Sample records for urban health center
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Art and community health: lessons from an urban health center.
Siegel, Wilma Bulkin; Bartley, Mary Anne
2004-01-01
Staff at a nurse-managed urban health center conducted a series of art sessions to benefit the community. The authors believe the program's success clearly communicated the relationship between art and community health. As a result of the success of the sessions, plans are in the works to make art a permanent part of the health center's services.
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Directory of Open Access Journals (Sweden)
Neda Kabiri
2015-08-01
Full Text Available Background and Objectives : Tracer methodology is a novel evaluation method which its purpose is to provide an accurate assessment of systems and processes for the delivery of care, treatment, and services at a health care organization. This study aimed to assess student care process in Tabriz using Tracer methodology. Material and Methods : This cross-sectional study was conducted in autumn 1391. Population study consisted of all the students who were covered by Tabriz health care center and study sample included an urban health care center, a rural health care center, a health house, and two schools in urban and rural areas which were selected by simple sampling method. Also, all the complicated and problematic processes were chosen to be assessed. Data were collected by interviewing, observing, and surveying documents and were compared with current standards. Results : The results of this study declared the percentage of points that each target group gained from tracer evaluation in student care process was 77% in health house, 90% in rural health care center and 83% in urban health care center. Findings indicated that documentation was the main weak point. Conclusion : According to the results of this study, student care process is sufficient; despite the fact that there are some deficiencies in caring process, as it may be improved through appropriate strategies. Furthermore, tracer methodology seems to be a proper method to evaluate various levels of health care system.
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Health Services Cost Analyzing in Tabriz Health Centers 2008
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Massumeh gholizadeh
2015-08-01
Full Text Available Background and objectives : Health Services cost analyzing is an important management tool for evidence-based decision making in health system. This study was conducted with the purpose of cost analyzing and identifying the proportion of different factors on total cost of health services that are provided in urban health centers in Tabriz. Material and Methods : This study was a descriptive and analytic study. Activity Based Costing method (ABC was used for cost analyzing. This cross–sectional survey analyzed and identified the proportion of different factors on total cost of health services that are provided in Tabriz urban health centers. The statistical population of this study was comprised of urban community health centers in Tabriz. In this study, a multi-stage sampling method was used to collect data. Excel software was used for data analyzing. The results were described with tables and graphs. Results : The study results showed the portion of different factors in various health services. Human factors by 58%, physical space 8%, medical equipment 1.3% were allocated with high portion of expenditures and costs of health services in Tabriz urban health centers. Conclusion : Based on study results, since the human factors included the highest portion of health services costs and expenditures in Tabriz urban health centers, balancing workload with staff number, institutionalizing performance-based management and using multidisciplinary staffs may lead to reduced costs of services.
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Rodriguez, J L; Peterson, D J; Muehlstedt, S G; Zera, R T; West, M A; Bubrick, M P
2001-10-01
Managed care and governmental policies have restructured hospital reimbursement. We examined reimbursement trends in trauma care to assess the impact of this market driven change on an urban academic health center. Patients injured between January 1997 and December 1999 were analyzed for Injury Severity Score (ISS), length of hospital stay, hospital cost, payer, and reimbursement. Between 1997 and 1999, the volume of patients with an ISS less than 9 increased and length of stay decreased. In addition, overall cost, payment, and profit margin increased. Commercially insured patients accounted for this margin increase, because the margins of managed care and government insured patients experienced double-digit decreases. Patients with ISS of 9 or greater also experienced a volume increase and a reduction in length of stay; however, costs within this group increased greater than payments, thereby reducing profit margin. Whereas commercially insured patients maintained their margin, managed care and government insured patients did not (double- and triple-digit decreases). Managed care and current governmental policies have a negative impact on urban academic health center reimbursement. Commercial insurers subsidize not only the uninsured but also the government insured and managed care patients as well. National awareness of this issue and policy action are paramount to urban academic health centers and may also benefit commercial insurers.
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Lessons Learned Recruiting Minority Participants for Research in Urban Community Health Centers.
Fam, Elizabeth; Ferrante, Jeanne M
2018-02-01
To help understand and mitigate health disparities, it is important to conduct research with underserved and underrepresented minority populations under real world settings. There is a gap in the literature detailing real-time research staff experience, particularly in their own words, while conducting in-person patient recruitment in urban community health centers. This paper describes challenges faced at the clinic, staff, and patient levels, our lessons learned, and strategies implemented by research staff while recruiting predominantly low-income African-American women for an interviewer-administered survey study in four urban Federally Qualified Health Centers in New Jersey. Using a series of immersion-crystallization cycles, fieldnotes and research reflections written by recruiters, along with notes from team meetings during the study, were qualitatively analyzed. Clinic level barriers included: physical layout of clinic, very low or high patient census, limited private space, and long wait times for patients. Staff level barriers included: unengaged staff, overburdened staff, and provider and staff turnover. Patient level barriers included: disinterested patients, patient mistrust and concerns over confidentiality, no-shows or lack of patient time, and language barrier. We describe strategies used to overcome these barriers and provide recommendations for in-person recruitment of underserved populations into research studies. To help mitigate health disparities, disseminating recruiters' experiences, challenges, and effective strategies used will allow other researchers to build upon these experience in order to increase recruitment success of underserved and underrepresented minority populations into research studies. Copyright © 2018 National Medical Association. Published by Elsevier Inc. All rights reserved.
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Wan, Fangjun; Xin, Zheng; Zhou, Lin; Bai, Li; Wang, Yongming; Gu, Shaohua; Liu, Shouqin; Li, Mengmeng; Sang, Shaowei; Zhang, Ji; Liu, Qiyong
2014-06-01
To find out the differences in regional characteristics of heat vulnerability between people living in urban centers and urban-fringe areas of Jinan city so as to provide basis for the development of adaptation measures to heat. A cross-sectional survey on heat vulnerability was conducted in urban center and urban-fringe areas of Jinan city, using a self-designed questionnaire among 801 residents at the age of 16 years or older in August 2013. Data of 23 indicators related to heat vulnerability were collected and aggregated to 7 dimensions:health and medical insurance, social networks, heat perception and adaptive behavior, economic status, resources, living environment and working environment. An index score was calculated using a balanced weighted average approach for each dimension, ranging from 0 to 1, with the closer to 1 as greater vulnerability. The scores on heat perception and adaptive behavior, economic status, resources and working environment dimensions for urban-fringe areas were 0.42,0.63,0.55 and 0.62, statistically significantly higher than the urban center area of 0.41,0.51,0.26 and 0.41. Scores of living environment, social networks and health/medical insurance dimensions for urban center area were 0.57,0.49 and 0.31, which were all higher than the urban-fringe areas of 0.50,0.46 and 0.25, with differences statistically significant. Residents living in the urban center might be more vulnerable to heat in terms of living environment, health/medical insurance and social networks while residents living in the urban-fringe areas might more be vulnerable in terms of heat perception and adaptive behavior, economic status, life resources and working environment. These facts indicated that heat vulnerability among residents could be quite different, even at a fine geographic sale. We would thus suggest that intervention strategies on protecting people from heat, should be more targeted.
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Directory of Open Access Journals (Sweden)
korosh Cheraghi pour
2010-02-01
Full Text Available Background: Toxoplasmosis is one of the a parasitic infectious caused by the protozoan Toxoplasma gondii. Congenital toxoplasmosis can cause abortion or fetus damage in pregnant women. The purpose of this study was to determine the seroprevalence of toxoplasmosis (IgG & IgM among the pregnant women referred to Aleshtar rural and urban health centers in 2008. Materials and Methods: Total 331 blood samples were collected from 204 urban and 127 rural pregnant wemon referred to rural and urban health centers of Aleshtar. After recording their information in the questionnaire and preparation of sample, all samples were evaluated with IgG- and IgM-ELISA to detect anti-Toxoplasma gondii antibodies. Data were analysed by descriptive statistics and chi-square test. Results: In this study seroprevalence of toxoplasmosis in urban and rural pregnant women were 36/2% and 44%, respectively. And 11. 2% of the urban and 9. 4% of the rural women suffered from acute Toxoplasma infection while 25% and 34. 6% of the urban and the rural cases had chronic infection, respectively. The results of analysis showed that there were significant relationships between seropositivity (IgG and IgM and education level, age, contact with raw meat, contact with cat, kind of food, washing vegetables, consumption of vegetables and milk in both urban and rural pregnant women (p<0. 05. There was no significant difference between seropositivity and other variables. Conclusion: The results of this study showed that the high level of education and preferment health awareness can reduce the risk of toxoplasmosis. Nevertheless, %60. 8 of the pregnant women in this study didn’t have previous history of toxoplasma infection and are exposed to primary infectin and acute disease. Therefore, preventive measures and controlled programs are necessary.
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International Nuclear Information System (INIS)
Shah, N.A.; Nisar, N.
2008-01-01
To assess level of awareness and pattern of utilizing family planning services among women (15-49 years) of reproductive age at Urban Health Center, Azizabad Sukkur, Sindh. A cross-sectional study was conducted from April to June 2005 at Urban Health Care Center Azizabad Sukkur. Two hundred women of reproductive age group were interviewed by using a pre tested semi structured questionnaire visiting the health care center during the study period. Information was obtained after taking informed consent regarding socio demographic characteristics, knowledge, attitude and pattern of utilizing family planning services. The data was entered and analyzed by using statistical package SPSS version 13. About 75% of women and 42.5% husbands were found illiterate, 85% women were housewives, 69.5% were married before 18 years of age and 54% had nuclear family. Regarding desired number of children women responded one child (3%), 2-3 children (11%), 4-5 (37.5%), more than five children (36%), 5.5% said that children are God gifted and 7% did not answer. About 60% of women reported use of at least one contraceptive method and 40% had never used any contraceptive method. The women who received counseling from the health care provider were 48.5% and only 6% received information through media. Religious prohibition, shortage of female staff and cost of family planning contraceptive methods were the main reasons identified for not utilizing contraceptive methods. The unsatisfactory variables were long waiting hours at the center, non-availability of contraceptive, shortage of the female staff and cost. Limited number of women was aware and practice contraception in the area and utilization of family planning services were low. The efforts should be made for providing information to couple and improving quality of family planning services in the area. (author)
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Denizard-Thompson, Nancy M; Feiereisel, Kirsten B; Stevens, Sheila F; Miller, David P; Wofford, James L
2011-06-01
Health care policy encourages better electronic connectivity between patient and the office practice. However, whether patients are able to partner with the practice in using communication technologies is not known. We sought to determine (1) the proportion of clinic patients who use internet and cell phone text messaging technologies, (2) the level of patient interest in using these technologies for the purpose of managing clinical appointments and patient education. Consecutive adult patients, clinicians and staff at an urban community health center were surveyed during a one-week period in order to estimate the frequency of technology use by patients. A total of 308 survey cards were collected during the designated week (response rate of 85% (308/362). One-third (34.0%, 105) of surveyed patients used the internet and text messaging daily or weekly, while nearly two-thirds (59.7%, 182) never used these technologies. There were no racial or gender differences in the proportion of patients who used the internet daily or weekly. In contrast, African-Americans used text messaging more often than whites (28.2 vs. 21.4%, P 50) used the internet and text messaging more often than older patients (50.6 vs. 16.6%, 44.3 vs. 7.3%, respectively). Despite the low use of both technologies, patient's interest in managing clinic appointments was high (40.3% for the Internet and 56.8% for text messaging). Clinicians and staff estimated patient's daily/weekly use of internet and cellphone messaging at 40.3% (± 22.0), and 56.8% (± 25.7), respectively. Most patients at this urban community health center reported never using the internet or cell phone text messaging. Clinicians overestimated technology use by patients. Planning for clinic infrastructure, quality improvement, and patient education should include assessment of technology use patterns by patients.
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Directory of Open Access Journals (Sweden)
Meera Muthukrishnan
2018-06-01
Full Text Available Background: Colorectal cancer (CRC is the second most common cancer in the US. Despite evidence that screening reduces CRC incidence and mortality, screening rates are sub-optimal with disparities by race/ethnicity, income, and geography. Rural-urban differences in CRC screening are understudied even though approximately one-fifth of the US population lives in rural areas. This focus on urban populations limits the generalizability and dissemination potential of screening interventions. Methods: Using community-based participatory research (CBPR principles, we designed a cluster-randomized trial, adaptable to a range of settings, including rural and urban health centers. We enrolled 483 participants across 11 health centers representing 2 separate networks. Both networks serve medically-underserved communities; however one is primarily rural and one primarily urban. Results: Our goal in this analysis is to describe baseline characteristics of participants and examine setting-level differences. CBPR was a critical for recruiting networks to the trial. Patient respondents were predominately female (61.3%, African-American (66.5%, and earned <$1200 per month (87.1%. The rural network sample was older; more likely to be female, white, disabled or retired, and have a higher income, but fewer years of education. Conclusions: Variation in the samples partly reflects the CBPR process and partly reflects inherent differences in the communities. This confirmed the importance of using CBPR when planning for eventual dissemination, as it enhanced our ability to work within diverse settings. These baseline findings indicate that using a uniform approach to implementing a trial or intervention across diverse settings might not be effective or efficient. Keywords: Colorectal cancer screening, Community-based participatory research, Health disparities, Medically underserved populations, Dissemination and implementation, Randomized trial
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Defining the medical imaging requirements for a rural health center
2017-01-01
This book establishes the criteria for the type of medical imaging services that should be made available to rural health centers, providing professional rural hospital managers with information that makes their work more effective and efficient. It also offers valuable insights into government, non-governmental and religious organizations involved in the planning, establishment and operation of medical facilities in rural areas. Rural health centers are established to prevent patients from being forced to travel to distant urban medical facilities. To manage patients properly, rural health centers should be part of regional and more complete systems of medical health care installations in the country on the basis of a referral and counter-referral program, and thus, they should have the infrastructure needed to transport patients to urban hospitals when they need more complex health care. The coordination of all the activities is only possible if rural health centers are led by strong and dedicated managers....
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Poverty and elimination of urban health disparities: challenge and opportunity.
Thomas, Stephen B; Quinn, Sandra Crouse
2008-01-01
The aim of this article is to examine the intersection of race and poverty, two critical factors fueling persistent racial and ethnic health disparities among urban populations. From the morass of social determinants that shape the health of racial and ethnic communities in our urban centers, we will offer promising practices and potential solutions to eliminating racial and ethnic health disparities.
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The framework of urban exposome: Application of the exposome concept in urban health studies.
Andrianou, Xanthi D; Makris, Konstantinos C
2018-05-02
Horizontal challenges, such as climate change or the growing populations, and their manifestations require the development of multidisciplinary research synergies in urban health that could benefit from concepts, such as the human exposome. Cities are composed of interconnected systems which are influenced, by global trends, national policies and local complexities. In this context, the exposome concept could be expanded having the city setting in its core, providing the conceptual framework for the new generation of urban studies. The objectives of this work were to define the urban exposome and outline its utility. The urban exposome can be defined as the continuous spatiotemporal surveillance/monitoring of quantitative and qualitative indicators associated with the urban external and internal domains that shape up the quality of life and the health of urban populations, using small city areas, i.e. neighborhoods, quarters, or smaller administrative districts, as the point of reference. Research should focus on the urban exposome's measurable units at different levels, i.e. the individuals, small, within-city areas and the populations. The urban exposome framework applied in the city of Limassol, Cyprus combines three elements: (i) a mixed-methods study on stakeholders' opinions about quality of life in the city; (ii) a systematic assessment of secondary data from the cancer and death registries, including city infrastructure data; and (iii) a population health and biomonitoring survey. Continuous assessment of environmental and health indicators that are routinely collected, and the incorporation of primary data from population studies, will allow for the timely identification of within-city health and environmental disparities to inform policy making and public health interventions. The urban exposome could facilitate evidence-based public health response, offering researchers, policy-makers, and citizens effective tools to address the societal needs of large
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Environmental risk factors of childhood asthma in urban centers.
Malveaux, F J; Fletcher-Vincent, S A
1995-09-01
Asthma morbidity and mortality are disproportionately high in urban centers, and minority children are especially vulnerable. Factors that contribute to this dilemma include inadequate preventive medical care for asthma management, inadequate asthma knowledge and management skills among children and their families, psychosocial factors, and environmental exposure to allergens or irritants. Living in substandard housing often constitutes excess exposure to indoor allergens and pollutants. Allergens associated with dust mites (DM) and cockroaches (CR) are probably important in both onset and worsening of asthma symptoms for children who are chronically exposed to these agents. Young children spend a great deal of time on or near the floor where these allergens are concentrated in dust. Of children (2 to 10 years of age) living in metropolitan Washington, DC, 60% were found to be sensitive to CR and 72% were allergic to DM. Exposure to tobacco smoke contributes to onset of asthma earlier in life and is a risk factor for asthma morbidity. Since disparity of asthma mortality and morbidity among minority children in urban centers is closely linked to socioeconomic status and poverty, measures to reduce exposure to environmental allergens and irritants and to eliminate barriers to access to health care are likely to have a major positive impact. Interventions for children in urban centers must focus on prevention of asthma symptoms and promotion of wellness.
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NIEHS/EPA CEHCs: Children's Environmental Health and Disease Prevention Center - Dartmouth College
The Columbia Center for Children’s Environmental Health (CCCEH) at Columbia University studies long-term health of urban pollutants on children raised in minority neighborhoods in inner-city communities.
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Risch, Martin R.; Ulberg, Amanda L.; Robinson, Bret A.
2007-01-01
An environmental assessment of the Muscatatuck Urban Training Center near Butlerville in Jennings County, Indiana, was completed during October and November 2005. As part of the Department of Defense Earth Science Program, the U.S. Geological Survey collected information about environmental conditions at the 825-acre former State of Indiana mental health facility prior to its conversion by the Indiana National Guard into an urban training center. The assessment was designed to investigate the type and extent of potential contamination associated with historical activities in selected areas of the facility.
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Beyond urban penalty and urban sprawl: back to living conditions as the focus of urban health.
Freudenberg, Nicholas; Galea, Sandro; Vlahov, David
2005-02-01
Researchers have long studied urban health, both to describe the consequences of urban living and to design interventions to promote the health of people living in cities. Two approaches to understanding the impact of cities on health have been dominant, namely, urban health penalty and urban sprawl. The urban penalty approach posits that cities concentrate poor people and expose them to unhealthy physical and social environments. Urban sprawl focuses on the adverse health and environmental effects of urban growth into outlying areas. We propose a model that integrates these approaches and emphasizes urban living conditions as the primary determinant of health. The aim of the model is to move beyond describing the health-related characteristics of various urban populations towards identifying opportunities for intervention. Such a shift in framework enables meaningful comparisons that can inform public health activities at the appropriate level and evaluate their effectiveness in improving the health of urban populations. The model is illustrated with two examples from current urban public health practice.
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Directory of Open Access Journals (Sweden)
Fatemeh Ghaffari
2013-12-01
Full Text Available Background and aim: Improving patient health status is the primary goal of healthcare system. and planning to improve the health care services without taking into account the views of care receivers is not possible .In this regard, Donabedian Model as an appropriate framework in assessing the quality of health care, has particular attention to the issue of "outcomes", which are sometimes seen as the most important indicators of quality. This study therefore aimed to assess the outcomes of preconception care including changes to health knowledge as well as patient satisfaction in urban health centers, Mashhad, Iran in 2012. Methods: In this descriptive study, 350 women of reproductive age who received preconception care in urban health centers of Mashhad, Iran, were selected using a two stage sampling design. Demographic and obstetric data were collected through a self-structured questionnaire. Outcomes of preconception care including health knowledge as well as patient satisfaction were measured using a questionnaire adopted from Donabedian Model. Data were analyzed with SPSS Software version 16 and statistical tests such as ANOVA, Chi-square and Pearson correlation coefficient. Findings: The mean age of women was 22.5 ± 26.93 and the mean score of their marriage years was 6.32±4.77. 67.4% of subjects experienced between one and six pregnancies. The mean score of health knowledge of preconception care was 53.4 ± 8.14 and the highest score of its subdomains was related to the personal hygiene. The mean score of patients' satisfaction of preconception care was 84.11 ± 56.75 and its highest score was in relation to counseling and provided care. Conclusion: According to the results, planning to provide better education services for clients, raising public awareness regarding preconception care and more emphasis on preconception care importance in continuous education of health care providers are recommended.
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Bullying among adolescents in a Brazilian urban center – “Health in Beagá” Study
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Michelle Ralil da Costa
2015-01-01
Full Text Available OBJECTIVE To analyze the prevalence of bullying and its associated factors in Brazilian adolescents.METHODS Data were used from a population-based household survey conducted by the Urban Health Observatory (OSUBH utilizing probability sampling in three stages: census tracts, residences, and individuals. The survey included 598 adolescents (14-17 years old who responded questions on bullying, sociodemographic characteristics, health-risk behaviors, educational well-being, family structure, physical activity, markers of nutritional habits, and subjective well-being (body image, personal satisfaction, and satisfaction with their present and future life. Univariate and multivariate analysis was done using robust Poisson regression.RESULTS The prevalence of bullying was 26.2% (28.0% among males, 24.0% among females. The location of most bullying cases was at or on route to school (70.5%, followed by on the streets (28.5%, at home (9.8%, while practicing sports (7.3%, at parties (4.6%, at work (1.7%, and at other locations (1.6%. Reports of bullying were associated with life dissatisfaction, difficulty relating to parents, involvement in fights with peers and insecurity in the neighborhood.CONCLUSIONS A high prevalence of bullying among participating adolescents was found, and the school serves as the main bullying location, although other sites such as home, parties and workplace were also reported. Characteristics regarding self-perception and adolescent perceptions of their environment were also associated with bullying, thus advancing the knowledge of this type of violence, especially in urban centers of developing countries.
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The Columbia Center for Children’s Environmental Health (CCCEH) at Columbia University studies long-term health of urban pollutants on children raised in minority neighborhoods in inner-city communities.
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Dye, Christopher
2008-02-08
The majority of people now live in urban areas and will do so for the foreseeable future. As a force in the demographic and health transition, urbanization is associated with falling birth and death rates and with the shift in burden of illness from acute childhood infections to chronic, noncommunicable diseases of adults. Urban inhabitants enjoy better health on average than their rural counterparts, but the benefits are usually greater for the rich than for the poor, thus magnifying the differences between them. Subject to better evidence, I suggest that the main obstacles to improving urban health are not technical or even financial, but rather are related to governance and the organization of civil society.
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Stefanov, W. L.; Stefanov, W. L.; Christensen, P. R.
2001-05-01
Land cover and land use changes associated with urbanization are important drivers of global ecologic and climatic change. Quantification and monitoring of these changes are part of the primary mission of the ASTER instrument, and comprise the fundamental research objective of the Urban Environmental Monitoring (UEM) Program. The UEM program will acquire day/night, visible through thermal infrared ASTER data twice per year for 100 global urban centers over the duration of the mission (6 years). Data are currently available for a number of these urban centers and allow for initial comparison of global city structure using spatial variance texture analysis of the 15 m/pixel visible to near infrared ASTER bands. Variance texture analysis highlights changes in pixel edge density as recorded by sharp transitions from bright to dark pixels. In human-dominated landscapes these brightness variations correlate well with urbanized vs. natural land cover and are useful for characterizing the geographic extent and internal structure of cities. Variance texture analysis was performed on twelve urban centers (Albuquerque, Baghdad, Baltimore, Chongqing, Istanbul, Johannesburg, Lisbon, Madrid, Phoenix, Puebla, Riyadh, Vancouver) for which cloud-free daytime ASTER data are available. Image transects through each urban center produce texture profiles that correspond to urban density. These profiles can be used to classify cities into centralized (ex. Baltimore), decentralized (ex. Phoenix), or intermediate (ex. Madrid) structural types. Image texture is one of the primary data inputs (with vegetation indices and visible to thermal infrared image spectra) to a knowledge-based land cover classifier currently under development for application to ASTER UEM data as it is acquired. Collaboration with local investigators is sought to both verify the accuracy of the knowledge-based system and to develop more sophisticated classification models.
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Differences in the use of spirometry between rural and urban primary care centers in Spain.
Márquez-Martín, Eduardo; Soriano, Joan B; Rubio, Myriam Calle; Lopez-Campos, Jose Luis
2015-01-01
The aim of this study is to evaluate the ability and practice of spirometry, training of technicians, and spirometry features in primary care centers in Spain, evaluating those located in a rural environment against those in urban areas. An observational cross-sectional study was conducted in 2012 by a telephone survey in 970 primary health care centers in Spain. The centers were divided into rural or urban depending on the catchment population. The survey contacted technicians in charge of spirometry and consisted of 36 questions related to the test that included the following topics: center resources, training doctors and technicians, using the spirometer, bronchodilator test, and the availability of spirometry and maintenance. Although the sample size was achieved in both settings, rural centers (RCs) gave a lower response rate than urban centers (UCs). The number of centers without spirometry in rural areas doubled those in the urban areas. Most centers had between one and two spirometers. However, the number of spirometry tests per week was significantly lower in RCs than in UCs (4 [4.1%] vs 6.9 [5.7%], Pspirometries was higher in RCs than in UCs (209 [73.0%] vs 207 [64.2%], P=0.003). RCs were more satisfied with the spirometries (7.8 vs 7.6, P=0.019) and received more training course for interpreting spirometry (41.0% vs 33.2%, P=0.004). The performance of the bronchodilator test showed a homogeneous measure in different ways. The spirometer type and the reference values were unknown to the majority of respondents. This study shows the differences between primary care RCs and UCs in Spain in terms of performing spirometry. The findings in the present study can be used to improve the performance of spirometry in these areas.
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Urban Extension: Aligning with the Needs of Urban Audiences Through Subject-Matter Centers
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Brad Gaolach
2017-06-01
Full Text Available The educational program model is the principle approach Extension uses to deliver on its mission of “taking knowledge to the people.” However, with county-based faculty fully engaged in long-term program delivery, they may have little or no capacity to address emerging issues faced by urban communities. Urban governments often seek the research capacity of a university in addition to, or instead of, the traditional Extension programming model but sometimes turn first to other urban-serving universities. Washington State University Extension has addressed these challenges by establishing subject-matter centers. This article examines how subject-matter centers can add capacity to traditional Extension offices in order to be responsive to emerging local needs, suggesting models that other university Extension programs may use or adapt to their local communities. These models also foster more community engagement and articulate greater public value for the institution as a whole.
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Urban Form, Air Pollution, and Health.
Hankey, Steve; Marshall, Julian D
2017-12-01
Urban form can impact air pollution and public health. We reviewed health-related articles that assessed (1) the relationships among urban form, air pollution, and health as well as (2) aspects of the urban environment (i.e., green space, noise, physical activity) that may modify those relationships. Simulation and empirical studies demonstrate an association between compact growth, improved regional air quality, and health. Most studies are cross-sectional and focus on connections between transportation emissions and land use. The physical and mental health impacts of green space, public spaces that promote physical activity, and noise are well-studied aspects of the urban environment and there is evidence that these factors may modify the relationship between air pollution and health. Urban form can support efforts to design clean, health-promoting cities. More work is needed to operationalize specific strategies and to elucidate the causal pathways connecting various aspects of health.
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Information, education, and communication services in MCH care provided at an urban health center
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Banerjee Bratati
2009-01-01
Full Text Available Background: Regular IEC programs during antenatal and intranatal period, through individual or group approach, brings desirable changes in health practices of people, resulting in a healthy mother and a healthy baby. Materials and Methods: This study was conducted to assess the level of IEC services regarding pregnancy and child care, received by the women at an MCH clinic of an urban health center, where the study subjects comprised 400 antenatal (AN and postnatal (PN women and mothers of children under five years. Results: Warning signs of danger was explained to only 10% of the AN and PN women. Advice regarding family planning appeared to be the most frequently covered, though that too was explained to less than half of the subjects. About one third of the women were advised on breast feeding. Only 8% of the mothers had been told about all issues regarding pregnancy and child care. Breast feeding and weaning was properly explained to 85.7 and 81.1% of the total mothers of U5 children. Advice regarding subsequent nutrition was given to 60.9% of mothers. About only a quarter of the total mothers were advised on home management of diarrhea and acute respiratory infections. Very few mothers were counseled about the growth pattern of the children and none were shown the growth chart. Only 12.9% of the mothers were informed about all issues. Conclusion: IEC regarding maternal and child care other than feeding practices is a neglected service in the health facility where the study was conducted.
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Center for Urban Environmental Research and Education (CUERE)
Federal Laboratory Consortium — The Center for Urban Environmental Research and Education (CUERE) at UMBC was created in 2001 with initial support from the U.S. Environmental Protection Agency and...
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Differences in the use of spirometry between rural and urban primary care centers in Spain
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Márquez-Martín E
2015-08-01
Full Text Available Eduardo Márquez-Martín,1 Joan B Soriano,2 Myriam Calle Rubio,3 Jose Luis Lopez-Campos1,4 On behalf of the 3E project 1Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS, Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Sevilla, 2Instituto de Investigación Hospital Universitario de la Princesa (IISP, Universidad Autónoma de Madrid, Cátedra UAM-Linde, 3Servicio de Neumología, Hospital Universitario Clínico San Carlos, 4Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES, Instituto de Salud Carlos III, Madrid, Spain Objectives: The aim of this study is to evaluate the ability and practice of spirometry, training of technicians, and spirometry features in primary care centers in Spain, evaluating those located in a rural environment against those in urban areas.Methods: An observational cross-sectional study was conducted in 2012 by a telephone survey in 970 primary health care centers in Spain. The centers were divided into rural or urban depending on the catchment population. The survey contacted technicians in charge of spirometry and consisted of 36 questions related to the test that included the following topics: center resources, training doctors and technicians, using the spirometer, bronchodilator test, and the availability of spirometry and maintenance.Results: Although the sample size was achieved in both settings, rural centers (RCs gave a lower response rate than urban centers (UCs. The number of centers without spirometry in rural areas doubled those in the urban areas. Most centers had between one and two spirometers. However, the number of spirometry tests per week was significantly lower in RCs than in UCs (4 [4.1%] vs 6.9 [5.7%], P<0.01. The availability of a specific schedule for conducting spirometries was higher in RCs than in UCs (209 [73.0%] vs 207 [64.2%], P=0.003. RCs were more satisfied with the spirometries (7.8 vs 7.6, P
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The Columbia Center for Children’s Environmental Health (CCCEH) at Columbia University studies long-term health of urban pollutants on children raised in minority neighborhoods in inner-city communities.
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de Snyder, V Nelly Salgado; Friel, Sharon; Fotso, Jean Christophe; Khadr, Zeinab; Meresman, Sergio; Monge, Patricia; Patil-Deshmukh, Anita
2011-12-01
The process of urbanization entails social improvements with the consequential better quality-of-life for urban residents. However, in many low-income and some middle-income countries, urbanization conveys inequality and exclusion, creating cities and dwellings characterized by poverty, overcrowded conditions, poor housing, severe pollution, and absence of basic services such as water and sanitation. Slums in large cities often have an absence of schools, transportation, health centers, recreational facilities, and other such amenities. Additionally, the persistence of certain conditions, such as poverty, ethnic heterogeneity, and high population turnover, contributes to a lowered ability of individuals and communities to control crime, vandalism, and violence. The social vulnerability in health is not a "natural" or predefined condition but occurs because of the unequal social context that surrounds the daily life of the disadvantaged, and often, socially excluded groups. Social exclusion of individuals and groups is a major threat to development, whether to the community social cohesion and economic prosperity or to the individual self-realization through lack of recognition and acceptance, powerlessness, economic vulnerability, ill health, diminished life experiences, and limited life prospects. In contrast, social inclusion is seen to be vital to the material, psychosocial, and political aspects of empowerment that underpin social well-being and equitable health. Successful experiences of cooperation and networking between slum-based organizations, grassroots groups, local and international NGOs, and city government are important mechanisms that can be replicated in urban settings of different low- and middle-income countries. With increasing urbanization, it is imperative to design health programs for the urban poor that take full advantage of the social resources and resourcefulness of their own communities.
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Smart urban design to reduce transportation impact in city centers
Fezzai, Soufiane; Mazouz, Said; Ahriz, Atef
2018-05-01
Air pollution is one of the most serious problems facing human being; urban wastes are in first range of energy consumption and emission of greenhouse gasses. Transportation or car traffic is one of the most consumer sectors of fuel, and most pollutant. Reducing energy consumption in transportation and the emission of pollutant gasses becomes an important objective for urban designers; many solutions may be proposed to help solving this problem in future designs, but it depend on other factors in existing urban space especially in city centers characterized with high occupation density. In this paper we investigate traffic rate in the city center of the case study, looking for the causes of the high traffic using gate count method and estimating fuel consumption. We try to propose some design solutions to reduce distances so fuel consumption and emission of pollutant gasses. We use space syntax techniques to evaluate urban configuration and verify the proposed solutions.
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Teachers' Perspectives of Children's Mental Health Service Needs in Urban Elementary Schools
Williams, James Herbert; Horvath, Violet E.; Wei, Hsi-Sheng; Van Dorn, Richard A.; Jonson-Reid, Melissa
2007-01-01
This study uses a phenomenological approach to investigate elementary school teachers' perspectives on children's mental health service needs. Focus groups were conducted at two elementary schools with differing levels of available social services in a moderate-sized urban midwestern school district. Data collection centered on six prominent…
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Urban mental health: Challenges and perspectives
DEFF Research Database (Denmark)
Okkels, Niels
2018-01-01
Purpose of review: To provide an update on urban mental health and highlight the challenges that require urgent attention. Recent findings: The majority of the world's population live in towns and urbanization is expected to increase in all areas of the world. Challenges to mental health in urban...... services. Fast and unstructured urbanization, such as that seen in many developing countries, further exacerbates these challenges. There are promising initiatives emerging including initiatives to end homelessness, to improve access to green areas in urban environments, to provide emergency psychiatric...
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Directory of Open Access Journals (Sweden)
Javadifar
2016-08-01
Full Text Available Background Healthy sexual function can be considered as an important element to improve personal and public hygiene. The sexual desire plays an important role in mental health and improving the quality of life. Objectives The current study aimed to compare sexual function of females in urban and rural areas. Methods The current descriptive study adopted 800 females of reproductive age (range 15 - 45 years referred to rural and urban healthcare centers in Ahvaz, Iran, in 2015. Samples were randomly selected. Applied instruments in the study were demographic information and female sexual dysfunction questionnaires (FSFI. Independent T-test, Chi-square and logistic regression were employed to analyze data by SPSS ver. 22. Results The result showed a significant statistical difference between females in urban and rural areas in terms of sexual desire, vaginal lubrication, intercourse pain and sexual function (P 0.05. Frequency of sexual dysfunction was 59.9% in females in rural and36.5% in urban areas and the difference between the groups was statistically significant (0.000. In both groups, the highest sexual disorder frequency was related to intercourse pain. Conclusions According to the obtained results, females in the rural areas had lower sexual function than the ones in the urban areas. It is suggested to establish female sexual health units in healthcare centers to give female sexual function consultation adjusted with awareness and culture of females and consider the existing problems.
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Urban distribution centers : a means to reducing freight vehicle miles traveled.
2011-02-01
The present study examines the model of freight consolidation platforms, and urban distribution centers (UDCs) in particular, as a means to solve the last mile problem of urban freight while reducing vehicle miles traveled and associated environmenta...
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Adolescent health in urban India
Directory of Open Access Journals (Sweden)
S Ramadass
2017-01-01
Full Text Available Adolescence is the period in human growth and development that occurs after childhood and before adulthood, from ages 10 to 19 years. It is a period of dynamic brain development. During this period, adolescents learn from the social behavior and environmental surroundings of their community. Because of rapid urbanization without accounting for the basic health-care amenities, health disparities tend to arise. In this review, we have tried to describe the health profile of adolescents in urban India. Relevant articles were extracted from PubMed and related websites. Adolescents in urban areas perceive their physical environment as very poor. Social capital and social cohesion are very important in their development. Increasing child marriage and poor antenatal care among adolescents are key challenges in improving the reproductive and sexual health. More than half of adolescents are undernourished. About 56% of adolescent girls are anemic. At this time of fighting against under-nutrition, burden of overweight and obesity is increasing among the urban adolescents. Mass media use and increased sedentary lifestyle increase the risk factors for noncommunicable diseases. Labile mental and emotional behavior makes them prone to suicide and intentional self-harm. Another avoidable key challenge among adolescents is addiction. Urban living and regular media exposure are positively associated with smoking and alcohol consumption. Among unintentional injuries, road traffic accidents dominate the picture. Various health programs targeting adolescent health have been launched in the recent past.
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The urban heat island and its impact on heat waves and human health in Shanghai.
Tan, Jianguo; Zheng, Youfei; Tang, Xu; Guo, Changyi; Li, Liping; Song, Guixiang; Zhen, Xinrong; Yuan, Dong; Kalkstein, Adam J; Li, Furong
2010-01-01
With global warming forecast to continue into the foreseeable future, heat waves are very likely to increase in both frequency and intensity. In urban regions, these future heat waves will be exacerbated by the urban heat island effect, and will have the potential to negatively influence the health and welfare of urban residents. In order to investigate the health effects of the urban heat island (UHI) in Shanghai, China, 30 years of meteorological records (1975-2004) were examined for 11 first- and second-order weather stations in and around Shanghai. Additionally, automatic weather observation data recorded in recent years as well as daily all-cause summer mortality counts in 11 urban, suburban, and exurban regions (1998-2004) in Shanghai have been used. The results show that different sites (city center or surroundings) have experienced different degrees of warming as a result of increasing urbanization. In turn, this has resulted in a more extensive urban heat island effect, causing additional hot days and heat waves in urban regions compared to rural locales. An examination of summer mortality rates in and around Shanghai yields heightened heat-related mortality in urban regions, and we conclude that the UHI is directly responsible, acting to worsen the adverse health effects from exposure to extreme thermal conditions.
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The delivery dispatching problem with time windows for urban consolidation centers
van Heeswijk, W.J.A.; Mes, Martijn R.K.; Schutten, Johannes M.J.
2015-01-01
This paper addresses the dispatch decision problem faced by an urban consolidation center. The center receives orders according to a stochastic arrival process, and dispatches them for the last-mile distribution in batches. The operator of the center aims to fi nd the cost-minimizing consolidation
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Directory of Open Access Journals (Sweden)
Qian Yang
2016-08-01
Full Text Available Urban ecosystem health evaluation can assist in sustainable ecological management at a regional level. This study examined urban agglomeration ecosystem health in the middle reaches of the Yangtze River with entropy weight and extension theories. The model overcomes information omissions and subjectivity problems in the evaluation process of urban ecosystem health. Results showed that human capital and education, economic development level as well as urban infrastructure have a significant effect on the health states of urban agglomerations. The health status of the urban agglomeration’s ecosystem was not optimistic in 2013. The majority of the cities were unhealthy or verging on unhealthy, accounting for 64.52% of the total number of cities in the urban agglomeration. The regional differences of the 31 cities’ ecosystem health are significant. The cause originated from an imbalance in economic development and the policy guidance of city development. It is necessary to speed up the integration process to promote coordinated regional development. The present study will aid us in understanding and advancing the health situation of the urban ecosystem in the middle reaches of the Yangtze River and will provide an efficient urban ecosystem health evaluation method that can be used in other areas.
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Lewis, Catherine; Deardorff, Julianna; Lahiff, Maureen; Soleimanpour, Samira; Sakashita, Kimi; Brindis, Claire D.
2015-01-01
Background: Bullying and victimization are ongoing concerns in schools. School health centers (SHCs) are well situated to support affected students because they provide crisis intervention, mental health care, and broader interventions to improve school climate. This study examined the association between urban adolescents' experiences of…
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Nature of urban interventions in changing the old center of a globalizing Doha
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Remah Y. Gharib
2014-12-01
Full Text Available Doha, Qatar is continuously positioning itself at the forefront of international urbanism with different qualities of expression in terms of economy, culture, and global outlook, and is characterized by fast-tracked urban development process with large-scale urban interventions in the old center. Although the unprecedented urban growth of this city continues to be a subject of discussion, little attention has been given to investigate the new interventions and the resulting effects they have on the old center. This study aims to examine three important urban interventions, namely, the Museum of Islamic Art, the reconstruction of the traditional market called Souq Waqif, and the Msheireb urban regeneration project. It examines local and global issues, universal standard practices, and traditional knowledge. This study employs a descriptive analysis of these interventions to explore the impact of change in the old center, exemplified by socio-spatial and typo-morphological aspects. Reference is made to a number of empirical studies, including behavioral mapping, GIS population statistics, and analysis of historical maps. Results analytically narrate the reactions of these interventions to the possibility of simultaneously adopting universal practices with local knowledge, and whether prioritizing local influences would represent narrow-mindedness in shaping the city.
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Bone, Curtis W; Goodfellow, Amelia M; Vahidi, Mani; Gelberg, Lillian
2018-02-01
Sexual violence (SV) is common; however, the prevalence of SV and its long term sequela vary geographically and among subpopulations within the USA. As such, the aims of this study are the following: (1) to determine the prevalence of SV, (2) to identify correlates of SV, and (3) to determine if SV is associated with depression among male and female risky drug users in urban Federally Qualified Health Centers (FQHCs) in Los Angeles. This study includes adult patients of five urban FQHCs who self-reported risky drug use. We identified survivors of SV and those experiencing depression through survey questions that queried, before or after age 18, "Were you ever sexually assaulted, molested or raped?" and with the RAND Mental Health Index (MHI-5). We utilized Pearson's chi-square tests to assess predictors of SV and logistic regression to assess for an association between SV and depression. Data collection took place from February 2011 to November 2012. Of the 334 study patients, 49% of females and 25% of males reported surviving SV. Exposure to SV, (both before 18 years of age and after 18 years of age) was the strongest predictor of depression among men and women in this study (OR 4.7, p < 0.05). These data demonstrate that sexual violence is prevalent in this urban FQHC population and is strongly associated with depression. Providers should consider screening both men and women with risky drug use for SV while health systems should continue to align mental health and primary care services to appropriately care for these extremely vulnerable patients. Trial Registration Clinical Trials. gov ID NCT01942876, Protocol ID DESPR DA022445, http://www.clinicaltrials.gov.
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Establishment of a Community-Based Mental Health Center in Yazd: A Short Report
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Golrasteh Kholasehzadeh
2016-10-01
Full Text Available About 40 years ago, the mental health services providing strategies have been dramatically changed worldwide. As well as, it is considered as a new revolution in mental health and named as community-based mental health movement. Moreover, mental health centers in Iran have been established in order to make a change in urban community-based mental health (CMHC. The first CMHC was founded in Tehran 16th district in 2010. In Yazd, it was established in 2010. In this article, the steps for establishment of the first CMHC were described.
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Job satisfaction of primary health-care providers (public sector in urban setting
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Pawan Kumar
2013-01-01
Full Text Available Introduction: Job satisfaction is determined by a discrepancy between what one wants in a job and what one has in a job. The core components of information necessary for what satisfies and motivates the health work force in our country are missing at policy level. Therefore present study will help us to know the factors for job satisfaction among primary health care providers in public sector. Materials and Methods: Present study is descriptive in nature conducted in public sector dispensaries/primary urban health centers in Delhi among health care providers. Pretested structured questionnaire was administered to 227 health care providers. Data was analyzed using SPSS and relevant statistical test were applied. Results: Analysis of study reveals that ANMs are more satisfied than MOs, Pharmacist and Lab assistants/Lab technicians; and the difference is significant (P < 0.01. Age and education level of health care providers don′t show any significant difference in job satisfaction. All the health care providers are dissatisfied from the training policies and practices, salaries and opportunities for career growth in the organization. Majority of variables studied for job satisfaction have low scores. Five factor were identified concerned with job satisfaction in factor analysis. Conclusion: Job satisfaction is poor for all the four groups of health care providers in dispensaries/primary urban health centers and it is not possible to assign a single factor as a sole determinant of dissatisfaction in the job. Therefore it is recommended that appropriate changes are required at the policy as well as at the dispensary/PUHC level to keep the health work force motivated under public sector in Delhi.
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Caiaffa, W T; Friche, A A L; Dias, M A S; Meireles, A L; Ignacio, C F; Prasad, A; Kano, M
2014-02-01
Detailed information on health linked to geographic, sociodemographic, and environmental data are required by city governments to monitor health and the determinants of health. These data are critical for guiding local interventions, resource allocation, and planning decisions, yet they are too often non-existent or scattered. This study aimed to develop a conceptual framework of Urban Health Observatories (UHOs) as an institutional mechanism which can help synthesize evidence and incorporate it into urban policy-making for health and health equity. A survey of a select group of existent UHOs was conducted using an instrument based on an a priori conceptual framework of key structural and functional characteristics of UHOs. A purposive sample of seven UHOs was surveyed, including four governmental, two non-governmental, and one university-based observatory, each from a different country. Descriptive and framework analysis methods were used to analyze the data and to refine the conceptual framework in light of the empirical data. The UHOs were often a product of unique historical circumstances. They were relatively autonomous and capable of developing their own locally sensitive agenda. They often had strong networks for accessing data and were able to synthesize them at the urban level as well as disaggregate them into smaller units. Some UHOs were identified as not only assessing but also responding to local needs. The findings from this study were integrated into a conceptual framework which illustrates how UHOs can play a vital role in monitoring trends in health determinants, outcomes, and equity; optimizing an intersectoral urban information system; incorporating research on health into urban policies and systems; and providing technical guidance on research and evidence-based policy making. In order to be most effective, UHOs should be an integral part of the urban governance system, where multiple sectors of government, the civil society, and businesses can
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U.S. Department of Health & Human Services — HRSA Health Centers care for you, even if you have no health insurance – you pay what you can afford based on your income. Health centers provide services that...
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Johns Hopkins Center for Childhood Asthma in the Urban Environment
Federal Laboratory Consortium — The long term goals of the Center for Childhood Asthma in the Urban Environment are to examine how exposures to environmental pollutants and allergens may relate to...
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Nature of urban interventions in changing the old center of a globalizing Doha
Gharib, Remah; Salama, Ashraf
2017-01-01
Doha, Qatar is continuously positioning itself at the forefront of international urbanism with different qualities of expression in terms of economy, culture, and global outlook, and is characterized by fast-tracked urban development process with large-scale urban interventions in the old center. Although the unprecedented urban growth of this city continues to be a subject of discussion, little attention has been given to investigate the new interventions and the resulting effects they have ...
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Afulani, Patience A; Diamond-Smith, Nadia; Golub, Ginger; Sudhinaraset, May
2017-09-22
Person-centered reproductive health care is recognized as critical to improving reproductive health outcomes. Yet, little research exists on how to operationalize it. We extend the literature in this area by developing and validating a tool to measure person-centered maternity care. We describe the process of developing the tool and present the results of psychometric analyses to assess its validity and reliability in a rural and urban setting in Kenya. We followed standard procedures for scale development. First, we reviewed the literature to define our construct and identify domains, and developed items to measure each domain. Next, we conducted expert reviews to assess content validity; and cognitive interviews with potential respondents to assess clarity, appropriateness, and relevance of the questions. The questions were then refined and administered in surveys; and survey results used to assess construct and criterion validity and reliability. The exploratory factor analysis yielded one dominant factor in both the rural and urban settings. Three factors with eigenvalues greater than one were identified for the rural sample and four factors identified for the urban sample. Thirty of the 38 items administered in the survey were retained based on the factors loadings and correlation between the items. Twenty-five items load very well onto a single factor in both the rural and urban sample, with five items loading well in either the rural or urban sample, but not in both samples. These 30 items also load on three sub-scales that we created to measure dignified and respectful care, communication and autonomy, and supportive care. The Chronbach alpha for the main scale is greater than 0.8 in both samples, and that for the sub-scales are between 0.6 and 0.8. The main scale and sub-scales are correlated with global measures of satisfaction with maternity services, suggesting criterion validity. We present a 30-item scale with three sub-scales to measure person-centered
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2010-10-01
..., migrant health centers and certain National Health Service Corps sites. 124.515 Section 124.515 Public... Unable To Pay § 124.515 Compliance alternative for community health centers, migrant health centers and... migrant health center under section 329 of the Act is in substantial compliance with the terms and...
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Martin, Julie L; Boyd, Linda D; Tapias-Perdigón, Helena; LaSpina, Lisa M
2017-10-01
Purpose: The purpose of this study was to assess the oral health needs of community-dwelling older adults participating in congregate meal centers and to determine whether differences exist in the oral health needs of older adult populations residing in urban versus rural communities in the state of Texas. Methods: Study participants were recruited at 6 congregate meal centers located in identified rural and urban communities in the greater metropolitan area of Austin, Texas. (N=78) Participants completed a validated, modified questionnaire containing 20 items on the following topics: self-reported oral health, tooth loss, dental insurance, frequency of dental visits, time since last dental visit, access to dental care, dry mouth, and oral cancer screening. Each participant received an oral health screening based on the Association of State and Territorial Dental Directors Basic Screening Survey for Older Adults. The examiners received hands-on training prior to the study to ensure the validity of their findings and to test for inter-examiner reliability.The chi-square test of independence was performed to analyze the participants' responses on the Basic Screening Survey to identify any relationships between the variables. Results: There were no significant differences in oral health conditions of older adults residing in urban versus rural communities. Over 50% of the participants (64.9% urban; 56.1% rural) reported incomes below $15,000 and lacked dental insurance to cover all or a portion of their oral health care needs. Eighty-seven percent of the participants reported tooth loss due to dental caries, 35% required periodontal care, and 37% reported occasional and 43% reported frequent oral pain over the last 12 months. Conclusions: Oral health promotion and disease prevention is an emergent need for older adult populations residing in urban and rural communities of the state of Texas. Analysis revealed that the majority of the older adult populations in both
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Public health emergencies in urban India
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Bhabani Prasad Acharya
2018-03-01
Full Text Available Public health emergencies in urban India can be caused by natural or man-made disasters. Occurrence of a public health emergency adds to the already stretched health system. This paper looks into the public health emergency conditions in urban India, and our preparedness to tackle them. To address this composite threat to nation’s health and development, a concerted public health response is needed, that can ensure efficient delivery in emergency situations Public health emergency is an occurrence or eminent threat of an illness or health condition caused by bio-terrorism, epidemic or pandemic disease, or novel and highly fatal infectious agent or biological toxin, that possess a substantial risk of a significant number of human facilities or incidents or permanent or long–term disability (1. It is a condition that requires the government to declare a state of public health emergency. The declaration of a state of public health emergency permits the government to suspend state regulations,and change the functions of state agencies (2. Term “Urban” refers to perplexing variety of environments. Health circumstances of small cities and town differ in many ways from larger cities and metros. Within cities, change in lifestyle of residents is observed. The urban system is often present with full array of health providers ranging from traditional healer, street drug seller to highly –trained surgeons (3.
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Urban environment and health: food security.
Galal, Osman; Corroon, Meghan; Tirado, Cristina
2010-07-01
The authors examine the impact of urbanization on food security and human health in the Middle East. Within-urban-population disparities in food security represent one of the most dramatic indicators of economic and health disparities. These disparities are reflected in a double burden of health outcomes: increasing levels of chronic disease as well as growing numbers of undernourished among the urban poor. These require further comprehensive solutions. Some of the factors leading to food insecurity are an overdependence on purchased food commodities, lack of sufficient livelihoods, rapid reductions in peripheral agricultural land, and adverse impacts of climate change. The Food and Agriculture Organization of the United Nations (FAO) Food Security Framework is used to examine and compare 2 cities in the Middle East: Amman, Jordan, and Manama, Bahrain.
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Baloye, David O; Palamuleni, Lobina G
2015-09-29
Growth in the commercialization, mobility and urbanization of human settlements across the globe has greatly exposed world urban population to potentially harmful noise levels. The situation is more disturbing in developing countries like Nigeria, where there are no sacrosanct noise laws and regulations. This study characterized noise pollution levels in Ibadan and Ile-Ife, two urban areas of Southwestern Nigeria that have experienced significant increases in population and land use activities. Eight hundred noise measurements, taken at 20 different positions in the morning, afternoon, and evening of carefully selected weekdays, in each urban area, were used for this study. Findings put the average noise levels in the urban centers at between 53 dB(A) and 89 dB (A), a far cry from the World Health Organization (WHO) permissible limits in all the land use types, with highest noise pollution levels recorded for transportation, commercial, residential and educational land use types. The result of the one-way ANOVA test carried out on the dependent variable noise and fixed factor land use types reveals a statistically significant mean noise levels across the study area (F(3,34) = 15.13, p = 0.000). The study underscores noise pollution monitoring and the urgent need to control urban noise pollution with appropriate and effective policies.
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The public health response to 'do-it-yourself' urbanism.
Sibbald, Shannon L; Graham, Ross; Gilliland, Jason
2017-09-01
Greater understanding of the important and complex relationship between the built environment and human health has made 'healthy places' a focus of public health and health promotion. While current literature concentrates on creating healthy places through traditional decision-making pathways (namely, municipal land use planning and urban design processes), this paper explores do-it-yourself (DIY) urbanism: a movement circumventing traditional pathways to, arguably, create healthy places and advance social justice. Despite being aligned with several health promotion goals, DIY urbanism interventions are typically illegal and have been categorized as a type of civil disobedience. This is challenging for public health officials who may value DIY urbanism outcomes, but do not necessarily support the means by which it is achieved. Based on the literature, we present a preliminary approach to health promotion decision-making in this area. Public health officials can voice support for DIY urbanism interventions in some instances, but should proceed cautiously.
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Ma, Fuchang; Lv, Fan; Xu, Peng; Zhang, Dapeng; Meng, Sining; Ju, Lahong; Jiang, Huihui; Ma, Liping; Sun, Jiangping; Wu, Zunyou
2015-07-02
The growing number of people living with HIV/AIDS (PLWHA) in China points to an increased need for case management services of HIV/AIDS. This study sought to explore the challenges and enablers in shifting the HIV/AIDS case management services from Centers for Disease Control and Prevention (CDCs) to Community Health Service Centers (CHSCs) in urban China. A qualitative method based on the Health Policy Triangle (HPT) framework was employed to gain in-depth insights into four elements of the task shifting strategy. This included a review on published literature and health policy documents, 15 focus group discussions (FGDs) and 30 in-depth interviews (IDIs) with four types of key actors from three cities in China. A total of 78 studies and 17 policy files at the national, municipal and local levels were obtained and reviewed comprehensively. Three semi-structured interview guides were used to explore key actors' views on shifting the HIV/AIDS case management services to CHSCs. It is necessary and feasible for CHSCs to engage in case management services for PLWHA in local communities. The increasing number of PLWHA and shortage of qualified health professionals in CDCs made shifting case management services downwards to CHSCs an urgent agenda. CHSCs' wide distribution, technical capacity, accessibility and current practice enabled them to carry out case management services for PLWHA. However our findings indicated several challenges in this task shifting process. Those challenges included lack of specific policy and stable financial support for CHSCs, inadequate manpower, relatively low capacity for health service delivery, lack of coordination among sectors, PLWHA's fear for discrimination and privacy disclosure in local communities, which may compromise the effectiveness and sustainability of those services. Shifting the HIV/AIDS case management services from CDCs to CHSCs is a new approach to cope with the rising number of PLWHA in China, but it should be
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Carotenoid coloration and health status of urban Eurasian kestrels (Falco tinnunculus).
Sumasgutner, Petra; Adrion, Marius; Gamauf, Anita
2018-01-01
As the world experiences rapid urban expansion, natural landscapes are being transformed into cities at an alarming rate. Consequently, urbanization is identified as one of the biggest environmental challenges of our time, yet we lack a clear understanding of how urbanization affects free-living organisms. Urbanization leads to habitat fragmentation and increased impervious surfaces affecting for example availability and quality of food. Urbanization is also associated with increased pollution levels that can affect organisms directly, via ecophysiological constraints and indirectly by disrupting trophic interactions in multi-species networks. Birds are highly mobile, while an individual is not necessarily exposed to urban stressors around the clock, but nestlings of altricial birds are. Such a city-dwelling species with a long nestling phase is the Eurasian kestrel (Falco tinnunculus) in Vienna, Austria, which forage on a diverse diet differing in composition from rural habitats. Furthermore, prey items vary in nutritional value and contents of micronutrients like carotenoids, which might impact the nestlings' health. Carotenoids are pigments that are incorporated into integument tissues but also have antioxidant and immunostimulatory capacity, resulting in a trade-off between these functions. In nestlings these pigments function in parent-offspring communication or sibling competition by advertising an individual's physical or physiological condition. Anthropogenic disturbance and pollutants could have disruptive effects on the coloration of these traits. In this study, we measured carotenoid based coloration and other indicators of individual health (body condition and susceptibility to the ectoparasite Carnus hemapterus) of 154 nestling kestrels (n = 91 nests) along an urban gradient from 2010 to 2015. We found skin yellowness of nestlings from nest-sites in the city-center to be least pronounced. This result might indicate that inner-city nestlings are
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Carotenoid coloration and health status of urban Eurasian kestrels (Falco tinnunculus.
Directory of Open Access Journals (Sweden)
Petra Sumasgutner
Full Text Available As the world experiences rapid urban expansion, natural landscapes are being transformed into cities at an alarming rate. Consequently, urbanization is identified as one of the biggest environmental challenges of our time, yet we lack a clear understanding of how urbanization affects free-living organisms. Urbanization leads to habitat fragmentation and increased impervious surfaces affecting for example availability and quality of food. Urbanization is also associated with increased pollution levels that can affect organisms directly, via ecophysiological constraints and indirectly by disrupting trophic interactions in multi-species networks. Birds are highly mobile, while an individual is not necessarily exposed to urban stressors around the clock, but nestlings of altricial birds are. Such a city-dwelling species with a long nestling phase is the Eurasian kestrel (Falco tinnunculus in Vienna, Austria, which forage on a diverse diet differing in composition from rural habitats. Furthermore, prey items vary in nutritional value and contents of micronutrients like carotenoids, which might impact the nestlings' health. Carotenoids are pigments that are incorporated into integument tissues but also have antioxidant and immunostimulatory capacity, resulting in a trade-off between these functions. In nestlings these pigments function in parent-offspring communication or sibling competition by advertising an individual's physical or physiological condition. Anthropogenic disturbance and pollutants could have disruptive effects on the coloration of these traits. In this study, we measured carotenoid based coloration and other indicators of individual health (body condition and susceptibility to the ectoparasite Carnus hemapterus of 154 nestling kestrels (n = 91 nests along an urban gradient from 2010 to 2015. We found skin yellowness of nestlings from nest-sites in the city-center to be least pronounced. This result might indicate that inner
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Nwameme, Adanna Uloaku; Tabong, Philip Teg-Nefaah; Adongo, Philip Baba
2018-03-20
Three-quarters of sub-Saharan Africa's urban population currently live under slum conditions making them susceptible to ill health and diseases. Ghana characterizes the situation in many developing countries where the urban poor have become a group much afflicted by complex health problems associated with their living conditions, and the intra-city inequity between them and the more privileged urban dwellers with respect to health care accessibility. Adopting Ghana's rural Community-Based Health Planning and Service (CHPS) programme in urban areas is challenging due to the differences in social networks and health challenges thus making modifications necessary. The Community Health Officers (CHOs) and their supervisors are the frontline providers of health in the community and there is a need to analyze and document the health sector response to urban CHPS. The study was solely qualitative and 19 in-depth interviews were conducted with all the CHOs and key health sector individuals in supervisory/coordinating positions working in urban CHPS zones to elicit relevant issues concerning urban CHPS implementation. Thematic content data analysis was done using the NVivo 7 software. Findings from this appraisal suggest that the implementation of this urban concept of the CHPS programme has been well undertaken by the health personnel involved in the process despite the challenges that they face in executing their duties. Several issues came to light including the lack of first aid drugs, as well as the need for the Integrated Management of Neonatal and Childhood Illnesses (IMNCI) programme and more indepth training for CHOs. In addition, the need to provide incentives for the volunteers and Community Health Committee members to sustain their motivation and the CHOs' apprehensions with regards to furthering their education and progression in their careers were key concerns raised. The establishment of the CHPS concept in the urban environment albeit challenging has been
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1 POPULATION PRESSURE AND HEALTH RISKS IN URBAN ...
African Journals Online (AJOL)
on urban market environment (and in this case, Bodija Market, Ibadan). Particular ... markets in most LDCs have become huge waste production centers. ... market. With about 90 percent of food purchases of urban residents being sourced from .... up a child's excrement in between attending to customers are created. Often ...
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Health and health-related indicators in slum, rural, and urban communities: a comparative analysis.
Mberu, Blessing U; Haregu, Tilahun Nigatu; Kyobutungi, Catherine; Ezeh, Alex C
2016-01-01
It is generally assumed that urban slum residents have worse health status when compared with other urban populations, but better health status than their rural counterparts. This belief/assumption is often because of their physical proximity and assumed better access to health care services in urban areas. However, a few recent studies have cast doubt on this belief. Whether slum dwellers are better off, similar to, or worse off as compared with rural and other urban populations remain poorly understood as indicators for slum dwellers are generally hidden in urban averages. The aim of this study was to compare health and health-related indicators among slum, rural, and other urban populations in four countries where specific efforts have been made to generate health indicators specific to slum populations. We conducted a comparative analysis of health indicators among slums, non-slums, and all urban and rural populations as well as national averages in Bangladesh, Kenya, Egypt, and India. We triangulated data from demographic and health surveys, urban health surveys, and special cross-sectional slum surveys in these countries to assess differences in health indicators across the residential domains. We focused the comparisons on child health, maternal health, reproductive health, access to health services, and HIV/AIDS indicators. Within each country, we compared indicators for slums with non-slum, city/urban averages, rural, and national indicators. Between-country differences were also highlighted. In all the countries, except India, slum children had much poorer health outcomes than children in all other residential domains, including those in rural areas. Childhood illnesses and malnutrition were higher among children living in slum communities compared to those living elsewhere. Although treatment seeking was better among slum children as compared with those in rural areas, this did not translate to better mortality outcomes. They bear a disproportionately
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Social and Architectural Aspects of Revitalization of Historic Urban Centers: Foreign Experience
Directory of Open Access Journals (Sweden)
Indrė Gražulevičiutė-Vileniškė
2011-03-01
Full Text Available The structure and architecture of many European cities has started their development during the Middle Ages or even earlier. The historic cores gradually had become centers of contemporary cities and are constantly evolving. They are affected by the tendencies of destruction, initiatives and movements of preservation are also taking place there. The comprehensive works of rehabilitation of Lithuanian historic urban centers were carried out during the period of soviet occupation. The insularity of the Soviet empire, ideological reasons and the absence of the private property has determined certain architectural expressions and solutions for the social problems. After the restoration of the country‘s independence the problems and tendencies typical to Western city centers, such as commercialization and gentrification, started to appear in Lithuanian historic urban cores. This justifies the aim of the article which is to analyze the tendencies of revitalization of historic city centers in Western countries with the main attention to the social and architectural aspects.Article in Lithuanian
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The delivery dispatching problem with time windows for urban consolidation centers
van Heeswijk, W.J.A.; Mes, Martijn R.K.; Schutten, Johannes M.J.
2015-01-01
This paper addresses the dispatch decision problem faced by an urban consolidation center. The center receives orders according to a stochastic arrival process, and dispatches them for the last-mile distribution in batches. The operator of the center aims to fi nd the cost-minimizing consolidation policy, depending on the orders at hand, pre-announced orders, and stochastic arrivals. We present this problem as a variant of the Delivery Dispatching Problem that includes dispatch windows, and m...
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Assessing the combined risks of PAHs and metals in urban soils by urbanization indicators
International Nuclear Information System (INIS)
Peng, Chi; Ouyang, Zhiyun; Wang, Meie; Chen, Weiping; Li, Xiaoma; Crittenden, John C.
2013-01-01
We quantitatively describe the impacts of urbanization on the accumulation of polycyclic aromatic hydrocarbons (PAHs) and heavy metals (HMs) in urban soils as well as their health risks to residents. Residential building age, population density, road density, and distance from urban center were used as urbanization level indicators. Significant correlations were found between those urbanization indicators and the amounts of PAHs, Cu, Cd, Pb, Zn and As in residential soils. The exposure time of soils to urban air was the primary factor affecting soil pollution, followed by local road density and population density. Factor analysis suggested that 59.0% of the elevated pollutant concentrations were caused by citywide uniform deposition, and 15.3% were resulted from short-range deposition and/or non-combustion processes. The combined health risks posed by soil PAHs and HMs were aggravated with time and can be expressed as functions of residence age, road density, and other urbanization indicators. Highlights: •The soil PAH and HM contents were closely related to urbanization progression. •The PAH and HM contents were primarily affected by soil exposure time. •Local input loads of pollutants correlated with road density and population density. •The combined risks of PAHs and HMs increased with the urban development level. •The carcinogenic risks of PAHs and As were above 10 −5 and increased over time. -- The health risks of PAHs and HMs in residential soils were connected to building age, population density and road density of the community as well as its distance from urban center
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Klein, Michael C.; Ciotoli, Carlo; Chung, Henry
2011-01-01
Objectives: This retrospective study analyzed a primary care depression screening initiative in a large urban university health center. Depression detection, treatment status, and engagement data are presented. Participants: Participants were 3,713 graduate and undergraduate students who presented consecutively for primary care services between…
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Insuring the uninsured: potential impact of Health Care Reform Act of 2010 on trauma centers.
Shafi, Shahid; Ogola, Gerald; Fleming, Neil; Rayan, Nadine; Kudyakov, Rustam; Barnes, Sunni A; Ballard, David J
2012-11-01
Viability of trauma centers is threatened by cost of care provided to patients without health insurance. The health care reform of 2010 is likely to benefit trauma centers by mandating universal health insurance by 2014. However, the financial benefit of this mandate will depend on the reimbursement provided. The study hypothesis was that compensation for the care of uninsured trauma patients at Medicare or Medicaid rates will lead to continuing losses for trauma centers. Financial data for first hospitalization were obtained from an urban Level I trauma center for 3 years (n = 6,630; 2006-2008) and linked with clinical information. Patients were grouped into five payments categories: commercial (29%), Medicaid (8%), Medicare (20%), workers' compensation (6%), and uninsured (37%). Prediction models for costs and payments were developed for each category using multiple regression models, adjusting for patient demographics, injury characteristics, complications, and survival. These models were used to predict payments that could be expected if uninsured patients were covered by different insurance types. Results are reported as net margin per patient (payments minus total costs) for each insurance type, with 95% confidence intervals, discounted to 2008 dollar values. Patients were typical for an urban trauma center (median age of 43 years, 66% men, 82% blunt, 5% mortality, and median length of stay 4 days). Overall, the trauma center lost $5,655 per patient, totaling $37.5 million over 3 years. These losses were encountered for patients without insurance ($14,343), Medicare ($4,838), and Medicaid ($15,740). Patients with commercial insurance were profitable ($5,295) as were those with workers' compensation ($6,860). Payments for the care of the uninsured at Medicare/Medicaid levels would lead to continued losses at $2,267 to $4,143 per patient. The health care reforms of 2010 would lead to continued losses for trauma centers if uninsured are covered with Medicare
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... care group, such as a community health center, hospital, or health department. A few are run by the school district itself. Centers often get money from charities and the government so they can give care ...
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Emina, Jacques; Beguy, Donatien; Zulu, Eliya M; Ezeh, Alex C; Muindi, Kanyiva; Elung'ata, Patricia; Otsola, John K; Yé, Yazoumé
2011-06-01
The Nairobi Urban Health and Demographic Surveillance System (NUHDSS) was set up in Korogocho and Viwandani slum settlements to provide a platform for investigating linkages between urban poverty, health, and demographic and other socioeconomic outcomes, and to facilitate the evaluation of interventions to improve the wellbeing of the urban poor. Data from the NUHDSS confirm the high level of population mobility in slum settlements, and also demonstrate that slum settlements are long-term homes for many people. Research and intervention programs should take account of the duality of slum residency. Consistent with the trends observed countrywide, the data show substantial improvements in measures of child mortality, while there has been limited decline in fertility in slum settlements. The NUHDSS experience has shown that it is feasible to set up and implement long-term health and demographic surveillance system in urban slum settlements and to generate vital data for guiding policy and actions aimed at improving the wellbeing of the urban poor.
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Mehta, Kedar; Pandya, Chandresh; Chavda, Paragkumar; Solanki, Dipak
2017-01-01
Health indicators of rural and urban India show a wide variation. Rural areas have received large focus in child health services, but on the flip side, urban areas have been the last to receive such attention. A cross-sectional study was conducted to include one randomly selected outreach session from all the 19 urban primary health centers of Vadodara city from April 2013 to May 2014. Nineteen session sites were observed for the process evaluation of three components of child health care, namely, "planning of Health and Nutrition Day," "availability of vaccines/logistics," and "direct observation of actual immunization process" at the site using a structured checklist. Most of the vaccines and logistics were present at all 19 sites visited, but adverse events following immunization kit were observed at ten sites (52%) only. Open vial policy, no-touch technique, and immediate cutting of syringe with hub cutter were implemented at all sites; however, completely filled Mamta Card was observed at 9 (47%) sites only. All four key messages were given at 5 (26%) sites only. Immunization services such as proper vaccine administration with no-touch technique and open vial policy were mainly focused; however, other services such as biomedical waste management, record keeping, and delivery of all four key messages need to be strengthened during Mamta Divas. Strengthening of other child health care services such as growth monitoring, Integrated Management of Neonatal and Childhood Illnesses, and referral services is required in urban areas.
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Definitions of urban areas feasible for examining urban health in the European Union.
Breckenkamp, Jürgen; Patterson, Lesley; Scharlach, Martina; Hellmeier, Wolfgang; Verma, Arpana
2017-05-01
As part of the EU-funded project, European Urban Health Indicator System (EURO-URHIS), a definition of urban areas (UAs) and of urban populations was needed to be able to identify comparable UAs in all member states. A literature review on existing definitions, as well as those used by other relevant projects, was performed. A survey of national experts in public health or land planning was also conducted. An algorithm was proposed to find UAs, which were feasible for the focus of EURO-URHIS. No unique general definition of UAs was found. Different fields of research define UAs differently. None of the definitions found were feasible for EURO-URHIS. All of them were found to have critical disadvantages when applied to an urban health project. An ideal definition for this type of project needs to provide a description of the situation without recourse to administrative boundaries yet inform the collection of routine data for urban health monitoring. These requirements were found to contradict each other and were not met in any existing definition. An algorithm was developed for the definition of UAs for the purpose of this study whereby national experts would select regions which are urban as an agglomeration or as a metropolitan area and which are potentially interesting in terms of public health; identify the natural boundaries, where countryside ends and residential or commercial areas of the region begin (e.g. by aerial photos); identify local government boundaries or other official boundaries used for routine data collection purposes which approximate the natural UA as closely as possible and list all administrative areas which are contained in the larger UA. The aggregation of all administrative areas within the original region formed the UA which was used in the project. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.
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Health and health-related indicators in slum, rural, and urban communities: a comparative analysis
Mberu, Blessing U.; Haregu, Tilahun Nigatu; Kyobutungi, Catherine; Ezeh, Alex C.
2016-01-01
Background It is generally assumed that urban slum residents have worse health status when compared with other urban populations, but better health status than their rural counterparts. This belief/assumption is often because of their physical proximity and assumed better access to health care services in urban areas. However, a few recent studies have cast doubt on this belief. Whether slum dwellers are better off, similar to, or worse off as compared with rural and other urban populations remain poorly understood as indicators for slum dwellers are generally hidden in urban averages. Objective The aim of this study was to compare health and health-related indicators among slum, rural, and other urban populations in four countries where specific efforts have been made to generate health indicators specific to slum populations. Design We conducted a comparative analysis of health indicators among slums, non-slums, and all urban and rural populations as well as national averages in Bangladesh, Kenya, Egypt, and India. We triangulated data from demographic and health surveys, urban health surveys, and special cross-sectional slum surveys in these countries to assess differences in health indicators across the residential domains. We focused the comparisons on child health, maternal health, reproductive health, access to health services, and HIV/AIDS indicators. Within each country, we compared indicators for slums with non-slum, city/urban averages, rural, and national indicators. Between-country differences were also highlighted. Results In all the countries, except India, slum children had much poorer health outcomes than children in all other residential domains, including those in rural areas. Childhood illnesses and malnutrition were higher among children living in slum communities compared to those living elsewhere. Although treatment seeking was better among slum children as compared with those in rural areas, this did not translate to better mortality
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Health and health-related indicators in slum, rural, and urban communities: a comparative analysis
Directory of Open Access Journals (Sweden)
Blessing U. Mberu
2016-12-01
Full Text Available Background: It is generally assumed that urban slum residents have worse health status when compared with other urban populations, but better health status than their rural counterparts. This belief/assumption is often because of their physical proximity and assumed better access to health care services in urban areas. However, a few recent studies have cast doubt on this belief. Whether slum dwellers are better off, similar to, or worse off as compared with rural and other urban populations remain poorly understood as indicators for slum dwellers are generally hidden in urban averages. Objective: The aim of this study was to compare health and health-related indicators among slum, rural, and other urban populations in four countries where specific efforts have been made to generate health indicators specific to slum populations. Design: We conducted a comparative analysis of health indicators among slums, non-slums, and all urban and rural populations as well as national averages in Bangladesh, Kenya, Egypt, and India. We triangulated data from demographic and health surveys, urban health surveys, and special cross-sectional slum surveys in these countries to assess differences in health indicators across the residential domains. We focused the comparisons on child health, maternal health, reproductive health, access to health services, and HIV/AIDS indicators. Within each country, we compared indicators for slums with non-slum, city/urban averages, rural, and national indicators. Between-country differences were also highlighted. Results: In all the countries, except India, slum children had much poorer health outcomes than children in all other residential domains, including those in rural areas. Childhood illnesses and malnutrition were higher among children living in slum communities compared to those living elsewhere. Although treatment seeking was better among slum children as compared with those in rural areas, this did not translate to
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Urbanization, economic development and health: evidence from China's labor-force dynamic survey.
Chen, Hongsheng; Liu, Ye; Li, Zhigang; Xue, Desheng
2017-11-29
The frequent outbreak of environmental threats in China has resulted in increased criticism regarding the health effects of China's urbanization. Urbanization is a double-edged sword with regard to health in China. Although great efforts have been made to investigate the mechanisms through which urbanization influences health, the effect of both economic development and urbanization on health in China is still unclear, and how urbanization-health (or development-health) relationships vary among different income groups remain poorly understood. To bridge these gaps, the present study investigates the impact of both urbanization and economic development on individuals' self-rated health and its underlying mechanisms in China. We use data from the national scale of the 2014 China Labor-force Dynamics Survey to analyze the impact of China's urbanization and economic development on health. A total of 14,791 individuals were sampled from 401 neighborhoods within 124 prefecture-level cities. Multilevel ordered logistic models were applied. Model results showed an inverted U-shaped relationship between individuals' self-rated health and urbanization rates (with a turning point of urbanization rate at 42.0%) and a positive linear relationship between their self-rated health and economic development. Model results also suggested that the urbanization-health relationship was inverted U-shaped for high- and middle-income people (with a turning point of urbanization rate at 0.0% and 49.2%, respectively), and the development-health relationship was inverted U-shaped for high- and low-income people (with turning points of GDP per capita at 93,462 yuan and 71,333 yuan, respectively) and linear for middle-income people. The impact of urbanization and economic development on health in China is complicated. Careful assessments are needed to understand the health impact of China's rapid urbanization. Social and environmental problems arising from rapid urbanization and economic growth
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Urban Green Space and Its Impact on Human Health
Kondo, Michelle C.; Fluehr, Jaime M.; McKeon, Thomas; Branas, Charles C.
2018-01-01
Background: Over half of the world’s population now lives in urban areas, and this proportion is expected to increase. While there have been numerous reviews of empirical studies on the link between nature and human health, very few have focused on the urban context, and most have examined almost exclusively cross-sectional research. This review is a first step toward assessing the possibility of causal relationships between nature and health in urban settings. Methods: Through systematic review of published literature, we explored the association between urban green space and human health. Results: We found consistent negative association between urban green space exposure and mortality, heart rate, and violence, and positive association with attention, mood, and physical activity. Results were mixed, or no association was found, in studies of urban green space exposure and general health, weight status, depression, and stress (via cortisol concentration). The number of studies was too low to generalize about birth outcomes, blood pressure, heart rate variability, cancer, diabetes, or respiratory symptoms. Conclusions: More studies using rigorous study design are needed to make generalizations, and meta-analyses, of these and other health outcomes possible. These findings may assist urban managers, organizations, and communities in their efforts to increase new or preserve existing green space. PMID:29510520
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Urbanization and health - An overview | Nnebue | Orient Journal of ...
African Journals Online (AJOL)
Urbanization and health - An overview. ... and health with emphasis on approach and options for the promotion of healthy behaviours and safety. ... The urban context of particular cities may also affect health as well as modify the effect that ...
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Measuring Health-related Transportation Barriers in Urban Settings.
Locatelli, Sara M; Sharp, Lisa K; Syed, Saming T; Bhansari, Shikhi; Gerber, Ben S
Access to reliable transportation is important for people with chronic diseases considering the need for frequent medical visits and for medications from the pharmacy. Understanding of the extent to which transportation barriers, including lack of transportation, contribute to poor health outcomes has been hindered by a lack of consistency in measuring or operationally defining "transportation barriers." The current study uses the Rasch measurement model to examine the psychometric properties of a new measure designed to capture types of transportation and associated barriers within an urban context. Two hundred forty-four adults with type 2 diabetes were recruited from within an academic medical center in Chicago and completed the newly developed transportation questions as part of a larger National Institutes of Health funded study (ClinicalTrials.gov identifier: NCT01498159). Results suggested a two subscale structure that reflected 1) general transportation barriers and 2) public transportation barriers.
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Tiwari, A.
2017-12-01
Current urban information mechanisms in developing countries operate only through linear exchanges between institutions and users and therefore reinforce hierarchical relationships. Coupled with conflicting interests and perspectives of stakeholders in multilevel climate-governance and absence of grassroots information-networking for adaptation decision-making, there are therefore, existing information gaps. Central to urban sustainability is the need for citizen centered transparency (CCT) mechanisms that encompass and address the needs of the marginalized and vulnerable communities in developing countries especially. The study discloses the existing information gaps through information-needs assessment of stakeholders, and attempts to chart the desired course for responsible action within frame-work of Citizen Centered Transparency (CCT) mechanism. This involved analysis of several urban development projects for Indian metropolitans that mainly involved end-user association, and the parameters considered for breaking complexity for assessment included: a. Feedback: Ends-user feedback to improve resource consumption literacy and consequently urban behaviour and sustainable lifestyles(feedback technology, consumption displays, eco-labeling, billing, advisory services, sensor technology), and b. Administrative Traditions and Institutional Policy: Rewarding-punishing to enforce desired action(subsidies, taxation). The research thus answered: 1.Who gets the information whereas who requires it (Equity in Information Distribution)? and 2. How can information translate to responsible action in future (Transparency of Execution)? Findings suggested that, how, by using the CCT innovations it is practically possible to embed responsibilities in urban development planning, and manifesting environmental goals in municipal policies so that they bear clear potential short-term benefits, short-term costs, and have maximum compliance with the objectives of sustainable urban
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Urban renewal, gentrification and health equity: a realist perspective.
Mehdipanah, Roshanak; Marra, Giulia; Melis, Giulia; Gelormino, Elena
2018-04-01
Up to now, research has focused on the effects of urban renewal programs and their impacts on health. While some of this research points to potential negative health effects due to gentrification, evidence that addresses the complexity associated with this relation is much needed. This paper seeks to better understand when, why and how health inequities arise from urban renewal interventions resulting in gentrification. A realist review, a qualitative systematic review method, aimed to better explain the relation between context, mechanism and outcomes, was used. A literature search was done to identify theoretical models of how urban renewal programs can result in gentrification, which in turn could have negative impacts on health. A systematic approach was then used to identify peer-reviewed studies that provided evidence to support or refute the initial assumptions. Urban renewal programs that resulted in gentrification tended to have negative health effects primarily in residents that were low-income. Urban renewal policies that were inclusive of populations that are vulnerable, from the beginning were less likely to result in gentrification and more likely to positively impact health through physical and social improvements. Research has shown urban renewal policies have significant impacts on populations that are vulnerable and those that result in gentrification can result in negative health consequences for this population. A better understanding of this is needed to impact future policies and advocate for a community-participatory model that includes such populations in the early planning stages.
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Directory of Open Access Journals (Sweden)
Kedar Mehta
2017-01-01
Full Text Available Introduction: Health indicators of rural and urban India show a wide variation. Rural areas have received large focus in child health services, but on the flip side, urban areas have been the last to receive such attention. Materials and Methods: A cross-sectional study was conducted to include one randomly selected outreach session from all the 19 urban primary health centers of Vadodara city from April 2013 to May 2014. Nineteen session sites were observed for the process evaluation of three components of child health care, namely, “planning of Health and Nutrition Day,” “availability of vaccines/logistics,” and “direct observation of actual immunization process” at the site using a structured checklist. Results: Most of the vaccines and logistics were present at all 19 sites visited, but adverse events following immunization kit were observed at ten sites (52% only. Open vial policy, no-touch technique, and immediate cutting of syringe with hub cutter were implemented at all sites; however, completely filled Mamta Card was observed at 9 (47% sites only. All four key messages were given at 5 (26% sites only. Conclusion: Immunization services such as proper vaccine administration with no-touch technique and open vial policy were mainly focused; however, other services such as biomedical waste management, record keeping, and delivery of all four key messages need to be strengthened during Mamta Divas. Strengthening of other child health care services such as growth monitoring, Integrated Management of Neonatal and Childhood Illnesses, and referral services is required in urban areas.
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Temperature, ozone, and mortality in urban and non-urban counties in the northeastern United States.
Madrigano, Jaime; Jack, Darby; Anderson, G Brooke; Bell, Michelle L; Kinney, Patrick L
2015-01-07
Most health effects studies of ozone and temperature have been performed in urban areas, due to the available monitoring data. We used observed and interpolated data to examine temperature, ozone, and mortality in 91 urban and non-urban counties. Ozone measurements were extracted from the Environmental Protection Agency's Air Quality System. Meteorological data were supplied by the National Center for Atmospheric Research. Observed data were spatially interpolated to county centroids. Daily internal-cause mortality counts were obtained from the National Center for Health Statistics (1988-1999). A two-stage Bayesian hierarchical model was used to estimate each county's increase in mortality risk from temperature and ozone. We examined county-level associations according to population density and compared urban (≥1,000 persons/mile(2)) to non-urban (PI: 0.08, 0.83) in urban counties, while this same increase in ozone was associated with a 0.73% increase (95% PI: 0.19, 1.26) in non-urban counties. An increase in temperature from 70°F to 90°F (21.2°C 32.2°C) was associated with a 8.88% increase in mortality (95% PI: 7.38, 10.41) in urban counties and a 8.08% increase (95% PI: 6.16, 10.05) in non-urban counties. County characteristics, such as population density, percentage of families living in poverty, and percentage of elderly residents, partially explained the variation in county-level associations. While most prior studies of ozone and temperature have been performed in urban areas, the impacts in non-urban areas are significant, and, for ozone, potentially greater. The health risks of increasing temperature and air pollution brought on by climate change are not limited to urban areas.
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Customer Quality during Prenatal Care in Health Care Centers in Tabriz City
Directory of Open Access Journals (Sweden)
Jafar Sadegh Tabrizi
2015-07-01
Full Text Available Background and Objectives : Customer Quality (CQ refers to customer’s characteristics and is concerned with the knowledge, skills and confidence of health services customers who actively participate with health team in proper decision-making, appropriate activities and changing environment and health related behaviors. The purpose of this study was measuring customer quality of pregnant women during prenatal care. Materials and Methods : This is a cross- sectional study which was conducted with the participation of 185 pregnant women who received prenatal care from urban health centers in Tabriz city. All participants were selected randomly from 40 health centers. Customer quality was measured based on CQMH-CQ questionnaire. Questionnaire content validity was reviewed and confirmed by 10 experts and its reliability was confirmed based on Cronbach's alpha index (α = 0.714. Spss v.17 was used for data analysis. Results : According to the results, the mean score of customer quality among pregnant women was (11.29± 67.79 and only %14 of the participants reported the highest customer quality score and ability of continuity of care under stressful situations. There was a positive relationship between customer quality score and visiting midwife and a better evaluation of overall quality of care, but there was inverse relationship with early registration at health centers. Conclusion : The participation of pregnant women in service delivery process and decision-making can promote costumer quality. Furthermore, training health care providers in empowering patients and using their abilities to improve quality of care and paying attention to patient-centered care will be helpful.
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Service utilization in community health centers in China: a comparison analysis with local hospitals
Directory of Open Access Journals (Sweden)
Wang Xiaohang
2006-08-01
Full Text Available Abstract Background Being an important part of China's Urban Health Care Reform System, Community Health Centers (CHCs have been established throughout the entire country and are presently undergoing substantial reconstruction. However, the services being delivered by the CHCs are far from reaching their performance targets. In order to assess the role of the CHCs, we examined their performance in six cities located in regions of South-East China. The purpose of this investigation was to identify the utilization and the efficiency of community health resources that are able to provide basic medical and public health services. Methods The study was approved by Peking University Health Science Center Institutional Reviewing Board (NO: IRB00001052-T1. Data were collected from all the local health bureaux and processed using SPSS software. Methods of analysis mainly included: descriptive analysis, paired T-test and one-way ANOVA. Results The six main functions of the CHCs were not fully exploited and the surveys that were collected on their efficiency and utilization of resources indicate that they have a low level of performance and lack the trust of local communities. Furthermore, the CHCs seriously lack funding support and operate under difficult circumstances, and residents have less positive attitudes towards them. Conclusion The community health service must be adjusted according to the requirements of urban medical and health reform, taking into account communities' health needs. More research is required on the living standards and health needs of residents living within the CHC's range, taking into consideration the users' needs in expanding the newly implemented service, and at the same time revising the old service system so as to make the development of CHCs realistic and capable of providing a better service to patients. Several suggestions are put forward for an attainable scheme for developing a community health service.
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Manzambi, J K; Tellier, V; Bertrand, F; Albert, A; Reginster, J Y; Van Balen, E H
2000-08-01
This study analyses the choice determinants of the population for health centres through a survey of the behaviour of families in a representative sample of 1,000 households in the health districts of Kinshasa, Congo in 1997. For the most recent episode of illness, the respondents turned to seven types of care: the health centre (37%), private dispensaries (26.5%), self-medication through a pharmacy (23.9%), traditional practitioner (21%), traditional self-medication (16.9%), private outpatients' clinic (16.7%) and a reference hospital (10.4%). Past logistics have shown that patients resort to a health centre rather than another type of care structure (P = 0.05) when looking for quality care, reasonable prices and the availability of varied services. On the other hand, concern about the geographical proximity in relation to the family's residence calls for using the private dispensary. When looking for a doctor or the existence of a 'convention', families are more inclined to choose a private officially recognized outpatients' clinic. Those who had been looking for a solution to a special type of illness opted primarily for a traditional practitioner. In conclusion, the results of this study show that if people choose the care offered by health centres, it is because they judge it to be of good quality. The integrated care offered by the same technician, with a required training, is a major asset in the acceptability of the first line of primary health care in Kinshasa. This study suggests that it would no doubt be beneficial to integrate non-official private care structures into the primary health care system, as far as it is possible for them to achieve a level of quality comparable to that of the health centres. In order that the traditional practitioner might play an important complementary role in the realization of primary health care, even in urban areas, the possibility of promoting sites of communication should be studied. Moreover, considering the weak
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Lai, Karen; Guo, Sisi; Ijadi-Maghsoodi, Roya; Puffer, Maryjane; Kataoka, Sheryl H
2016-12-01
School-based health centers (SBHCs) reduce access barriers to mental health care and improve educational outcomes for youths. This qualitative study evaluated the innovations and challenges of a unique network of SBHCs in a large, urban school district as the centers attempted to integrate health, mental health, and educational services. The 43 participants sampled included mental health providers, primary care providers, and care coordinators at 14 SBHCs. Semistructured interviews with each participant were audio recorded and transcribed. Themes were identified and coded by using Atlas.ti 5.1 and collapsed into three domains: operations, partnership, and engagement. Interviews revealed provider models ranging from single agencies offering both primary care and mental health services to colocated services. Sites where the health agency provided at least some mental health services reported more mental health screenings. Many sites used SBHC wellness coordinators and coordination team meetings to facilitate relationships between schools and health agency and community mental health clinic providers. Partnership challenges included confidentiality policies and staff turnover. Participants also highlighted student and parent engagement through culturally sensitive services, peer health advocates, and "drop-in" lunches. Staffing and operational models are critical in the success of integrating primary care, mental health care, and education. Among the provider models observed, the combined primary care and mental health provider model offered the most integrated services. Despite barriers, providers and schools have begun to implement novel solutions to operational problems and family engagement in mental health services.
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Environmental risk factors of childhood asthma in urban centers.
Malveaux, F J; Fletcher-Vincent, S A
1995-01-01
Asthma morbidity and mortality are disproportionately high in urban centers, and minority children are especially vulnerable. Factors that contribute to this dilemma include inadequate preventive medical care for asthma management, inadequate asthma knowledge and management skills among children and their families, psychosocial factors, and environmental exposure to allergens or irritants. Living in substandard housing often constitutes excess exposure to indoor allergens and pollutants. Alle...
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Pereira, Clifford; Boyd, J Brian; Dickenson, Brian; Putnam, Brant
2012-04-01
Gunshot wounds (GSWs) to the face are an infrequent occurrence outside of a war zone. However, when they occur, they constitute a significant reconstructive challenge. We present our 10-year experience at an urban level I trauma center to define the patterns of injury, assess the morbidity and mortality, and estimate the cost to the health care system. A retrospective review was performed on all patients admitted to Harbor-UCLA Medical Center with GSWs to the head and neck region between January 1997 and January 2007. Those who had sustained GSWs to the face requiring operative intervention were closely reviewed. Between 1997 and 2007, a total of 702 patients were admitted to the Harbor UCLA Emergency Department having sustained GSWs to the head and neck region, of which 501 patients survived. Of the survivors, 28 patients (26 male, 2 female) sustained GSWs to their face requiring operative intervention. The mean age of these patients was 28 (±8.3) years. They generally presented within a few hours of the injury, but 1 individual arrived over 24 hours later. Low-velocity single gunshots (from handguns) were predominantly involved, with facial fractures occurring in all cases. Fractures were of a localized shattering type without the major displacement of bony complexes seen in motor vehicle accidents. Most required wound debridement and fracture fixation. A few patients (14.2%) underwent free tissue transfer for reconstruction (3 fibular flaps, 1 TRAM). Tracheostomy was performed in 35.7% of patients. Mean length of hospital stay was 8.3 (±7.1) days, with 50% of cases requiring admission to the intensive care unit. Mean length of intensive care unit stay was 5.2 (±5.7) days. The average cost per patient exceeded $100,000.
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Shi, Leiyu; Lee, De-Chih; Liang, Hailun; Zhang, Luwen; Makinen, Marty; Blanchet, Nathan; Kidane, Ruth; Lindelow, Magnus; Wang, Hong; Wu, Shaolong
2015-11-30
Reform of the health care system in urban areas of China has prompted concerns about the utilization of Community Health Centers (CHC). This study examined which of the dominant primary care delivery models, i.e., the public CHC model, the 'gate-keeper' CHC model, or the hospital-owned CHC models, was most effective in enhancing access to and quality of care for patients with chronic illness. The case-comparison design was used to study nine health care organizations in Guangzhou, Dongguan, and Shenzhen cities within Guangdong province, China. 560 patients aged 50 or over with hypertension or diabetes who visited either CHCs or hospitals in these three cities were surveyed by using face-to-face interviews. Bivariate analyses were performed to compare quality and value of care indicators among subjects from the three cities. Multivariate analyses were used to assess the association between type of primary care delivery and quality as well as value of chronic care after controlling for patients' demographic and health status characteristics. Patients from all three cities chose their current health care providers primarily out of concern for quality of care (both provider expertise and adequate medical equipment), patient-centered care, and insurance plan requirement. Compared with patients from Guangzhou, those from Dongguan performed significantly better on most quality and value of care indicators. Most of these indicators remained significantly better even after controlling for patients' demographic and health status characteristics. The Shenzhen model (hospital-owned and -managed CHC) was generally effective in enhancing accessibility and continuity. However, coordination suffered due to seemingly duplicating primary care outpatients at the hospital setting. Significant associations between types of health care facilities and quality of care were also observed such that patients from CHCs were more likely to be satisfied with traveling time and follow-up care by
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Health and the urban environment: revolutions revisited
Energy Technology Data Exchange (ETDEWEB)
McGranahan, Gordan
2009-05-15
From cholera pandemics to smog episodes, urban development driven by narrow economic interests has shown itself to be a serious threat to human health and wellbeing. Past revolutions in sanitation and pollution control demonstrate that social movements and governance reforms can transform an urban health penalty into a health advantage. But many environmental problems have been displaced over time and space, and never truly resolved. Health concerns need once again to drive an environmental agenda – but this time it must be sustainable over the long haul, and globally equitable. With the global economic crisis raising the ante, what's needed is no less than a revolution in environmental justice that puts health, not economics, at the core of its values.
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Mental well-being of migrants in urban center of India: Analyzing the role of social environment.
Firdaus, Ghuncha
2017-01-01
Rural to urban migration has become a salient feature of the country. However, there is a dearth of study highlighting impact of this movement on mental health of the migrant people. The main objective of the present study was to examine the relationship between specific components of social environment and psychological well-being of migrants in an urban center. The National Capital Territory of Delhi was selected for intensive study and has an exploratory design supported by cross-sectional primary data. A standardized questionnaire was used to obtain data about the socioeconomic characteristics of the respondents. For measuring the mental well-being, the World Health Organization Well-Being Index (WHO5) was used. The required information was procured through interview method from 1230 sampled respondents. Influence of socioeconomic variables on mental well-being of the people was estimated through multivariate logistic regression methods. For different combinations of risk factors, five models were developed based on unstandardized likelihood coefficients. Poor mental health was significantly higher among single/widow/divorced/separated (odds ratio [OR] =0.76, P income level ( P < 0.001) were positively related to mental health. Poor housing conditions ( P < 0.001), adjustment problem ( P < 0.001), and feeling insecure ( P < 0.01) were independent predictors of poor mental health. Socioeconomic and environmental problem caused by the migrants and faced by the migrants is required in-depth study to formulate comprehensive policies.
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Environmental Health in Relation to Urban Planning and Human Physical Activity
International Nuclear Information System (INIS)
Oliver, L.H.L.; Siti Nur Afiqah Mohamed Musthafa; Dasimah Omar
2015-01-01
The world is changing everyday in a fast pace that makes majority of the urbanized areas becoming more congested and polluted by the development. The planning of the urban world has brought about a great impact towards the environment and health. With the large number of human population, urban areas will have various kinds of activities that contributed to the higher rate of pollutants compared to areas with less development. In a car oriented urban development pattern, majority of the population will choose automobiles as their transportation modes rather than walking or cycling. Due to that, the air emission in urban areas will increase rapidly, and reduce the physical activity. Air pollutants contribute to various health problems, especially respiratory infection. Besides, lacking of physical activities also increase the health risk. However, there is limited study on the relationship between urban land use setting and health in developing country. Thus, a study had been carried out to establish the relationship between urban setting and human health. It involved air quality data collection, observation on land use setting, and questionnaire survey on human health and the lifestyle. Findings from the relationship analysis had been discussed with suitable recommendation and conclusion. (author)
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Health care practices influencing health promotion in urban black women in Tshwane
Directory of Open Access Journals (Sweden)
SCD Wright
2008-09-01
Full Text Available Health promotion is a multifaceted activity. Women and children are particularly vulnerable regarding access to quality health care, with young African women reportedly the poorest and most economically marginalised and least educated sector in South Africa. Understanding the context within which a person lives is an essential component in the health educator’s teaching strategy. Understanding urban black women’s health care practices will enable health promoters to develop interventions that are successful. The problem investigated was to gain an understanding of the health care practices of urban black women that could influence health promotion activities. The design was qualitative exploratory. The respondents were women living in an urban township in Tshwane, South Africa. The sampling method was convenient and purposive and the sample size was determined by saturation of the data. Data was gathered through semi-structured interviews using six specific themes and the analysed using open coding. The results indicated that the social environment created by the registered nurses in the primary health influenced the health care practices of the women negatively. Practices regarding the seriousness of a health problem suggest a possible reason for late admission of a person with a serious health problem.
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The Organizational Health of Urban Elementary Schools: School Health and Teacher Functioning.
Mehta, Tara G; Atkins, Marc S; Frazier, Stacy L
2013-09-01
This study examined the factor structure of the Organizational Health Inventory-Elementary version (OHI-E; Hoy, Tarter, & Kottkamp, 1991) in a sample of 203 teachers working in 19 high-poverty, urban schools and the association of organizational school health with teacher efficacy, teacher stress, and job satisfaction. Results indicated a similar factor structure of the OHI-E as compared with the population of schools in the original sample (Hoy et al., 1991), and that specific components of organizational health, such as a positive learning environment, are associated with teacher efficacy, stress, and satisfaction. Overall, teachers' relations with their peers, their school leadership, and their students appear especially critical in high-poverty, urban schools. Recommendations for research and practice related to improving high-poverty, urban schools are presented.
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Evaluation of a Worksite Diabetes Education Program at a Large Urban Medical Center.
Renda, Susan; Baernholdt, Marianne; Becker, Kathleen
2016-01-01
Evidence suggests that diabetes education can be delivered at the worksite to better support employees' diabetes self-management and improve productivity and health care costs. This study was conducted to address the feasibility of a diabetes worksite education program for employees at a large urban academic health care institution. The diabetes education program was delivered in the diabetes center at the institution, a resource that was previously underutilized by employees. Through collaboration with groups in the institution, 20 employees of diverse ethnicity participated in the worksite diabetes education program with positive outcomes: improved glycemic control measured (HbA1c), attainment of self-management goals, and satisfaction with the program. Work absences trended downward, but numbers of hospitalizations and emergency department visits were unchanged in the 3 months following education. Recommendations include replication of the study with more employee participation and program evaluation over a longer period of time to continue assessment of employees' educational needs. © 2015 The Author(s).
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Population health and urban form : a review of the literature
International Nuclear Information System (INIS)
2004-11-01
A review examining the links between public health and living spaces was presented. The aim of the review was to explore whether different urban forms created communities that encouraged healthy living and resulted in a healthier population as well as to suggest avenues and approaches for further research of the subject in British Columbia. The historical links between public health and community planning were examined. A conceptual model of the linkages of urban form and population health was developed and used to identify ways in which urban form and population health are linked. Areas of concern include vehicle emissions, water quality and heat build-up as well as noise pollution. Issues concerning health inequalities related to income and access to health services were examined, as well as the role that urban form plays as a barrier to physical activity. Findings indicated that there is a strong correlation between urban form and health. Lower density urban forms that require a vehicle generated more miles travelled by car with more traffic crashes and higher risks to pedestrians and cyclists. A growing body of evidence has indicated that community contacts are scarcer in low density areas. In addition, low density dwellers seemed to have higher stress levels. Car dependent lifestyles had negative impacts on children's play, growth and development. Urban forms which promoted a range of housing options in terms of affordability, tenure and type allowed people to remain within their neighbourhoods. Disadvantaged groups fared better in denser areas where there were more public facilities. 62 refs. 1 tab., 2 figs
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The less healthy urban population: income-related health inequality in China
2012-01-01
Background Health inequality has been recognized as a problem all over the world. In China, the poor usually have less access to healthcare than the better-off, despite having higher levels of need. Since the proportion of the Chinese population living in urban areas increased tremendously with the urbanization movements, attention has been paid to the association between urban/rural residence and population health. It is important to understand the variation in health across income groups, and in particular to take into account the effects of urban/rural residence on the degree of income-related health inequalities. Methods This paper empirically assesses the magnitude of rural/urban disparities in income-related adult health status, i.e., self-assessed health (SAH) and physical activity limitation, using Concentration Indices. It then uses decomposition methods to unravel the causes of inequalities and their variations across urban and rural populations. Data from the China Health and Nutrition Survey (CHNS) 2006 are used. Results The study finds that the poor are less likely to report their health status as “excellent or good” and are more likely to have physical activity limitation. Such inequality is more pronounced for the urban population than for the rural population. Results from the decomposition analysis suggest that, for the urban population, 76.47 per cent to 79.07 per cent of inequalities are driven by non-demographic/socioeconomic-related factors, among which income, job status and educational level are the most important factors. For the rural population, 48.19 per cent to 77.78 per cent of inequalities are driven by non-demographic factors. Income and educational attainment appear to have a prominent influence on inequality. Conclusion The findings suggest that policy targeting the poor, especially the urban poor, is needed in order to reduce health inequality. PMID:22989200
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The less healthy urban population: income-related health inequality in China.
Yang, Wei; Kanavos, Panos
2012-09-18
Health inequality has been recognized as a problem all over the world. In China, the poor usually have less access to healthcare than the better-off, despite having higher levels of need. Since the proportion of the Chinese population living in urban areas increased tremendously with the urbanization movements, attention has been paid to the association between urban/rural residence and population health. It is important to understand the variation in health across income groups, and in particular to take into account the effects of urban/rural residence on the degree of income-related health inequalities. This paper empirically assesses the magnitude of rural/urban disparities in income-related adult health status, i.e., self-assessed health (SAH) and physical activity limitation, using Concentration Indices. It then uses decomposition methods to unravel the causes of inequalities and their variations across urban and rural populations. Data from the China Health and Nutrition Survey (CHNS) 2006 are used. The study finds that the poor are less likely to report their health status as "excellent or good" and are more likely to have physical activity limitation. Such inequality is more pronounced for the urban population than for the rural population. Results from the decomposition analysis suggest that, for the urban population, 76.47 per cent to 79.07 per cent of inequalities are driven by non-demographic/socioeconomic-related factors, among which income, job status and educational level are the most important factors. For the rural population, 48.19 per cent to 77.78 per cent of inequalities are driven by non-demographic factors. Income and educational attainment appear to have a prominent influence on inequality. The findings suggest that policy targeting the poor, especially the urban poor, is needed in order to reduce health inequality.
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The less healthy urban population: income-related health inequality in China
Directory of Open Access Journals (Sweden)
Yang Wei
2012-09-01
Full Text Available Abstract Background Health inequality has been recognized as a problem all over the world. In China, the poor usually have less access to healthcare than the better-off, despite having higher levels of need. Since the proportion of the Chinese population living in urban areas increased tremendously with the urbanization movements, attention has been paid to the association between urban/rural residence and population health. It is important to understand the variation in health across income groups, and in particular to take into account the effects of urban/rural residence on the degree of income-related health inequalities. Methods This paper empirically assesses the magnitude of rural/urban disparities in income-related adult health status, i.e., self-assessed health (SAH and physical activity limitation, using Concentration Indices. It then uses decomposition methods to unravel the causes of inequalities and their variations across urban and rural populations. Data from the China Health and Nutrition Survey (CHNS 2006 are used. Results The study finds that the poor are less likely to report their health status as “excellent or good” and are more likely to have physical activity limitation. Such inequality is more pronounced for the urban population than for the rural population. Results from the decomposition analysis suggest that, for the urban population, 76.47 per cent to 79.07 per cent of inequalities are driven by non-demographic/socioeconomic-related factors, among which income, job status and educational level are the most important factors. For the rural population, 48.19 per cent to 77.78 per cent of inequalities are driven by non-demographic factors. Income and educational attainment appear to have a prominent influence on inequality. Conclusion The findings suggest that policy targeting the poor, especially the urban poor, is needed in order to reduce health inequality.
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Assessing the combined risks of PAHs and metals in urban soils by urbanization indicators.
Peng, Chi; Ouyang, Zhiyun; Wang, Meie; Chen, Weiping; Li, Xiaoma; Crittenden, John C
2013-07-01
We quantitatively describe the impacts of urbanization on the accumulation of polycyclic aromatic hydrocarbons (PAHs) and heavy metals (HMs) in urban soils as well as their health risks to residents. Residential building age, population density, road density, and distance from urban center were used as urbanization level indicators. Significant correlations were found between those urbanization indicators and the amounts of PAHs, Cu, Cd, Pb, Zn and As in residential soils. The exposure time of soils to urban air was the primary factor affecting soil pollution, followed by local road density and population density. Factor analysis suggested that 59.0% of the elevated pollutant concentrations were caused by citywide uniform deposition, and 15.3% were resulted from short-range deposition and/or non-combustion processes. The combined health risks posed by soil PAHs and HMs were aggravated with time and can be expressed as functions of residence age, road density, and other urbanization indicators. Copyright © 2013 Elsevier Ltd. All rights reserved.
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Urban as a determinant of health.
Vlahov, David; Freudenberg, Nicholas; Proietti, Fernando; Ompad, Danielle; Quinn, Andrew; Nandi, Vijay; Galea, Sandro
2007-05-01
Cities are the predominant mode of living, and the growth in cities is related to the expansion of areas that have concentrated disadvantage. The foreseeable trend is for rising inequities across a wide range of social and health dimensions. Although qualitatively different, this trend exists in both the developed and developing worlds. Improving the health of people in slums will require new analytic frameworks. The social-determinants approach emphasizes the role of factors that operate at multiple levels, including global, national, municipal, and neighborhood levels, in shaping health. This approach suggests that improving living conditions in such arenas as housing, employment, education, equality, quality of living environment, social support, and health services is central to improving the health of urban populations. While social determinant and multilevel perspectives are not uniquely urban, they are transformed when viewed through the characteristics of cities such as size, density, diversity, and complexity. Ameliorating the immediate living conditions in the cities in which people live offers the greatest promise for reducing morbidity, mortality, and disparities in health and for improving quality of life and well being.
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Kumar, Vivek; Kumar, Satish; Chandra Sharma, Naresh; Kumar, Badal
2017-10-01
To recognize deaths in the otorhinolaryngology indoor wards, determine the reason behind the mortalities and recommend modifications for betterment of patient care and surgical outcomes. Data was collected from the mortality register, operation theatre registers, ward registers and case notes of patients declared dead at an urban tertiary health care center in India for a period of 5 years; from January 2012 to December 2016. The data included date of admission, age, sex, educational status, residence, and clinical diagnosis, course of hospital stay and medical cause of death. Data acquired was reviewed and statistically interpreted and presented in graphical and descriptive formats. 6157 admissions were made in otorhinolaryngology (ENT) ward in the 5 year period which included 3969 males and 2188 female patients. 58 deaths were recorded during this period which gives overall death per admission crude mortality rate of 9.42% at an average of about 12 (11.60) deaths per year. The major causes of death were malignancy and septicemia. The significance of health education, aggressive healthcare campaigns, enhancement of healthcare services and wide accessibility of healthcare services to remote areas has been emphasized. Role of structured study and protocols in the management of serious cases is highlighted along with the need for prompt referral and better interdepartmental cooperation. Copyright © 2017 Chang Gung University. Published by Elsevier B.V. All rights reserved.
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Zhu, Y. G.
2015-12-01
China has the largest population in the world, and by 2011, more than 50% of its population are now living in cities. This ongoing societal change has profound impacts on environmental quality and population health. In addition to intensive discharges of waste, urbanization is not only changing the land use and land cover, but also inducing fundamental changes in biogeochemical processes. Unlike biogeochemistry in non-urban environment, the biological component of urban biogeochemistry is dominated by direct human activities, such as air pollution derived from transport, wastewater treatment, garbage disposal and increase in impervious surface etc. Managing urban biogeochemistry will include source control over waste discharge, eco-infrastructure (such as green space and eco-drainage), resource recovery from urban waste stream, and integration with peri-urban ecosystem, particularly with food production system. The overall goal of managing urban biogeochemistry is for human health and wellbeing, which is a global challenge. In this paper, the current status of urban biogeochemistry research in China will be briefly reviewed, and then it will focus on nutrient recycling and waste management, as these are the major driving forces of environmental quality changes in urban areas. This paper will take a holistic view on waste management, covering urban metabolism analysis, technological innovation and integration for resource recovery from urban waste stream, and risk management related to waste recycling and recovery.
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Substance abuse in outpatients attending rural and urban health ...
African Journals Online (AJOL)
Substance abuse in outpatients attending rural and urban health centres in Kenya. ... Objectives: To estimate the prevalence and pattern of substance use among patients attending primary health centres in urban and rural areas of Kenya. Design: A ... Socio-cultural factors might be responsible for the differences noted.
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76 FR 17139 - Health Center Program
2011-03-28
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Health Center Program AGENCY: Health Resources and Services Administration, HHS. ACTION: Notice of Noncompetitive... Improvement Project (CIP) from Saint Vincent's Catholic Medical Centers (SVCMC) of New York, current grantee...
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Psychological health among Chinese college students: a rural/urban comparison.
Zhang, Jie; Qi, Qing; Delprino, Robert P
2017-09-01
The literature on suicide among the Chinese indicates that younger individuals from rural areas are at higher risk of suicide than their urban counterparts. While earlier studies have investigated the relationship between psychological health and major demographic variables, the relationship of psychological health as it relates to suicide by those from urban and rural areas have been rare. Studying the psychological health of college students from rural China in comparison with students who originate from urban areas may shed light on the mental health disparities of the two populations. This study examined the relationship of psychological health and rural/urban origins of college students in China. Data was obtained from 2 400 college students who completed a survey questionnaire while in attendance at a key university in Beijing China in 2013. Four standardised psychological health scales were administered to obtain measures of participants' self-esteem, depression, social support, and suicide ideation. Findings indicated that urban students had significantly higher scores than their rural counterparts on self-esteem and social support. However, there was no statistically significant difference between the groups on measures of depression and suicide ideation.
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The Organizational Health of Urban Elementary Schools: School Health and Teacher Functioning
Mehta, Tara G.; Atkins, Marc S.; Frazier, Stacy L.
2013-01-01
This study examined the factor structure of the Organizational Health Inventory-Elementary version (OHI-E; Hoy, Tarter, & Kottkamp, 1991) in a sample of 203 teachers working in 19 high-poverty, urban schools and the association of organizational school health with teacher efficacy, teacher stress, and job satisfaction. Results indicated a similar factor structure of the OHI-E as compared with the population of schools in the original sample (Hoy et al., 1991), and that specific components of organizational health, such as a positive learning environment, are associated with teacher efficacy, stress, and satisfaction. Overall, teachers’ relations with their peers, their school leadership, and their students appear especially critical in high-poverty, urban schools. Recommendations for research and practice related to improving high-poverty, urban schools are presented. PMID:23935763
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Toward improved public health outcomes from urban nature.
Shanahan, Danielle F; Lin, Brenda B; Bush, Robert; Gaston, Kevin J; Dean, Julie H; Barber, Elizabeth; Fuller, Richard A
2015-03-01
There is mounting concern for the health of urban populations as cities expand at an unprecedented rate. Urban green spaces provide settings for a remarkable range of physical and mental health benefits, and pioneering health policy is recognizing nature as a cost-effective tool for planning healthy cities. Despite this, limited information on how specific elements of nature deliver health outcomes restricts its use for enhancing population health. We articulate a framework for identifying direct and indirect causal pathways through which nature delivers health benefits, and highlight current evidence. We see a need for a bold new research agenda founded on testing causality that transcends disciplinary boundaries between ecology and health. This will lead to cost-effective and tailored solutions that could enhance population health and reduce health inequalities.
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Odey, Emmanuel Alepu; Li, Zifu; Zhou, Xiaoqin; Kalakodio, Loissi
2017-10-01
The problems posed by fecal sludge (FS) are multidimensional because most cities rapidly urbanize, which results in the increase in population, urban settlement, and waste generation. Issues concerning health and waste treatment have continued to create alarming situations. These issues had indeed interfered with the proper steps in managing FS, which contaminates the environment. FS can be used in agriculture as fertilizer because it is an excellent source of nutrients. The recent decline in crop production due to loss of soil organic component, erosion, and nutrient runoff has generated interest in the recycling of FS into soil nutrients through stabilization and composting. However, human feces are considerably liable to spread microorganisms to other persons. Thus, sanitation, stabilization, and composting should be the main objectives of FS treatment to minimize the risk to public and environmental health. This review presents an improved FS management (FSM) and technology option for soil amendment that is grouped into three headings, namely, (1) collection, (2) treatment, and (3) composting. On the basis of the literature review, the main problems associated with the collection and treatment of FS, such as inadequate tools and improper treatment processes, are summarized, and the trends and challenges that concern the applicability of each of the technologies in developing urban centers are critically reviewed. Stabilization during pretreatment before composting is suggested as the best method to reduce pathogens in FS. Results are precisely intended to be used as a support for decisions on policies and strategies for FSM and investments for improved treatment facilities.
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Evans, Megan L; Breeze, Janis L; Paulus, Jessica K; Meadows, Audra
The aim of this study was to assess the impact of a revolving loan fund (RLF) on timing of device insertion and long-acting reversible contraception (LARC) access among a high-risk urban population at 3 Boston community health centers. Three health centers were identified to implement a RLF. Each clinic received $5000 from the RLF to purchase LARC devices. Data collected through medical record review retrospectively 1 year prior to start of the RLF and prospectively for 1 year thereafter included patient demographics, type of LARC selected, patient's date of documented interest in a LARC device, and date of insertion. The effect of a RLF on delay to LARC insertion was tested using negative binomial regression, controlling for site and potential confounding variables between the pre- and post-RLF periods. Three urban community health centers. Reproductive-aged women who received family planning services at the 3 participating health centers. Increasing access to LARC and decreasing wait times to LARC insertion after implementation of the RLF. Data on 133 patients in the pre-RLF group and 205 in the post-RLF group were collected. There were no statistically significant differences in demographic or clinical characteristics between the 2 time periods. LARC uptake increased significantly from the pre- to post-RLF period, specifically among implant users. There was a statistically significant decrease in the mean number of days in delay from interest to insertion from the pre- to post-RLF period (pre-RLF: 31.3 ± 50.6 days; post-RLF: 13.6 ± 16.7 days, adjusted P < .001). The reasons for the delay did not differ significantly between the 2 time periods. The RLF decreased wait time for the devices and increased overall insertion rates. This may serve as a promising solution to improve LARC access in community health centers. This project could be expanded to include more health centers, creating a city wide RLF. This expansion could allow for further data analysis
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Alhassan, Robert Kaba; Beyere, Christopher B; Nketiah-Amponsah, Edward; Mwini-Nyaledzigbor, Prudence P
2017-01-01
The population of Ghana is increasingly becoming urbanized with about 70% of the estimated 27 million people living in urban and peri-urban areas. Nonetheless, eight out of the ten regions in Ghana remain predominantly rural where only 32% of the national health sector workforce works. Moreover, the rural-urban disparities in the density of health tutors (staff responsible for pre-service training of health professionals) are enormous. This paper explores perceived needs of health tutors in rural and urban health training institutions in Ghana. This is a descriptive qualitative study conducted in the Greater Accra and Northern regions of Ghana. The Study used the deductive thematic and sub-thematic analysis approaches. Five health training institutions were randomly sampled, and 72 tutors engaged in separate focus group discussions with an average size of 14 participants per group in each training institution. Perceived rural-urban disparities among health tutors were found in the payment of extra duty allowances; school infrastructure including libraries and internet connectivity; staff accommodation; and opportunities for scholarships and higher education. Health tutors in rural areas generally expressed more frustration with these work conditions than those in urban areas. There is the need to initiate and sustain work incentives that promote motivation of rural health tutors to control ongoing rural-urban migration of qualified staff. It is recommended the following incentives be prioritized to promote retention of qualified health tutors in rural health training schools: payment of research, book and rural allowances; early promotion of rural staff; prioritizing rural tutors for scholarships, and introduction of national best health tutor awards.
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Directory of Open Access Journals (Sweden)
H Rostami
2013-06-01
Full Text Available Background and purpose:Consumption of baking soda, as a primary material for preparation of bread dough, has been banned due to its health complications in Iran. So bread production in our country faced difficulties and one part of them is related to health issues which are bread production. Also, in some cases, baking soda is used in the bread production. This study was done to study the environmental health status and consumption of baking soda in the military and urban Lavash bakeries of Tehran in 2012. Materials and methods:This is a descriptive comparative study done on Lavash bread production of 14 military bakeries and 14 corresponding urban bakeries near them. PH in the samples was tested based on Institute of Standards and Industrial Research of Iran No. 2628. To check the status of environmental health and personal hygiene of bakeries, the check list of Cereal Research Center was used. Results:In terms of environmental health status,28.6% military bakeries and7.1% urban bakeries were at good level. In terms of personal hygiene, all bakeries were in the poor category. Also,42.9% of military Lavash bakeries and 14.3% of urban Lavash bakeries used baking soda in their bread production. Conclusion:Environment health and personal hygiene status in military bakeries are better than the urban bakeries however, hygiene status was not desirable in military bakeries. Also, baking soda consumption in military bakeries was more common than the urban bakeries. According to the results of this study, control of health status and avoiding baking soda consumption in the bakeries are necessary.
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Directory of Open Access Journals (Sweden)
G.G. Mchunu
2009-09-01
Full Text Available The study aimed to describe the practice of community involvement in health programmes.The study therefore explored the nature and practice of community involvementin health programmes in the two communities in KwaZulu Natal. Thestudy was guided by the conceptual framework adapted from Amstein’s,( 1969 Ladderof Citizen Participation. This framework shows different levels and steps in communityparticipation. A case study method was used to conduct the study. The twocases were one urban based and one rural based community health centers in theIlembe health district, in Kwa Zulu Natal. A sample of 31 persons participated in thestudy. The sample comprised 8 registered nurses, 2 enrolled nurses 13 communitymembers and 8 community health workers. Data was collected using structured individualinterviews and focus group interviews, and was guided by the case protocol.Community involvement in health largely depended on the type of community, withrural community members being in charge of their health projects and urban communitymembers helping each other as neighbours in times of need.
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Directory of Open Access Journals (Sweden)
Ali Agha nouri
2012-01-01
Full Text Available Objectives: To improve quality of life in the elderly through proper plans and active involvement of elderly in their family and community, we should get a lot of information about health-related quality of life because the composition of our population has changed. Infact, the aged population is increasingly growing, that this will, in turn, have an effect on economic progression and well-being in the country. Thus, this study assessed quality of life and its determinants in the people aged 60 years and over living in the urban areas of Central Province. Methods & Materials: This study was a cross-sectional descriptive-analytic survey that included 165 elderly peoples in the urban areas of Markazi Province. Data was obtained via a general and a quality of life (using SF-36 questionnaire. The results were analyzed by Chi-Square, Fisher, independent T-test, ANOVA, Regression, and Pearson correlation coefficient. Results: The average age of the subjects was 70.7 years (men 44.8% and women 55.2%. The mean of total SF-36, physical and mental components' scores were 55.66±22, 51.32±21 and 57.30±25 respectively. Additionally, the mean scores of eight health-related dimensions were as follows: physical functions 56.26±45, role limitations due to physical problems 50.60±27, body pain 51.26±38, general health 45.26±53, vitality 53.24±09, social functioning 67.85±27, role limitations due to mental problems 57.14±45 and mental health 62.88±25. Also, the quality of life scores were significantly associated with sex, previous employment, leisure activities, income, current exercising, present disease and drug consumption (P<0.05. Conclusion: Results showed that the elderly's quality of life in the urban areas in Markazi province is in the middle level and the individuals have better mental health compared to physical health. Moreover, various factors are associated with the elderly’s quality of life, which require comprehensive planning for
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Mulligan, K; Elliott, S J; Schuster-Wallace, C
2012-05-01
This case study investigates the connections among urban planning, governance and dengue fever in an emerging market context in the Global South. Key informant interviews were conducted with leading figures in public health, urban planning and governance in the planned city of Putrajaya, Malaysia. Drawing on theories of urban political ecology and ecosocial epidemiology, the qualitative study found the health of place - expressed as dengue-bearing mosquitoes and dengue fever in human bodies in the urban environment - was influenced by the place of health in a hierarchy of urban priorities. Copyright © 2012 Elsevier Ltd. All rights reserved.
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Some structural aspects of urbanization in Ethiopia.
Rafiq, M; Hailemariam, A
1987-07-01
This article studies the emerging patterns of urbanization in Ethiopia. Over the period from 1967-1984, a number of structural changes have occurred which are likely to play a dominant role in the future urban growth in Ethiopia. In spite of its long history of settled population, Ethiopia did not witness sustained growth of urban centers. Ethiopia is 1 of the least urbanized areas in the Third World. A 3rd aspect of urbanization in Ethiopia is the wide range of regional differentials in the level of urbanization. Most of the urban population is concentrated in 2 administrative regions--Shoa and Eritrea. A more balanced urban growth may, inter alia, involve a better spread in terms of higher education, industrialization, provision of health and social services, and the development of communication and commercial infrastructure. Another striking feature of urbanization in Ethiopia is that growth has not been disproportionately concentrated in the largest urban centers. The largest urban centers have not assumed an inordinately higher level of primacy. The basic form of the curve depicting the relationship between the size of a locality and its rank has remained unchanged over the period. The post-revolution land reforms and the new socioeconomic structure emerging from reorganization of the society appear to have a rural-urban migration inhibiting effect. Some of the country's regional differentials may be associated with environmental factors.
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Assessing Heat Health Risk for Sustainability in Beijing’s Urban Heat Island
Directory of Open Access Journals (Sweden)
Weihua Dong
2014-10-01
Full Text Available This research is motivated by the increasing threat of urban heat waves that are likely worsened by pervasive global warming and urbanization. Different regions of the city including urban, borderland and rural area will experience different levels of heat health risk. In this paper, we propose an improved approach to quantitatively assess Beijing’s heat health risk based on three factors from hazard, vulnerability and especially environment which is considered as an independent factor because different land use/cover types have different influence on ambient air temperatures under the Urban Heat Island effect. The results show that the heat health risk of Beijing demonstrates a spatial-temporal pattern with higher risk in the urban area, lower risk in the borderland between urban and rural area, and lowest risk in the rural area, and the total risk fluctuated dramatically during 2008–2011. To be more specific, the heat health risk was clearly higher in 2009 and 2010 than in 2008 and 2011. Further analysis with the urban area at sub-district level signifies that the impervious surface (urban area such as buildings, roads, et al. ratio is of high correlation with the heat health risk. The validation results show that the proposed method improved the accuracy of heat health risk assessment. We recommend that policy makers should develop efficient urban planning to accomplish Beijing’s sustainable development.
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Lungu, Edgar Arnold; Biesma, Regien; Chirwa, Maureen; Darker, Catherine
2018-06-01
In many developing countries including Malawi, health indicators are on average better in urban than in rural areas. This phenomenon has largely prompted Governments to prioritize rural areas in programs to improve access to health services. However, considerable evidence has emerged that some population groups in urban areas may be facing worse health than rural areas and that the urban advantage may be waning in some contexts. We used a descriptive study undertaking a comparative analysis of 13 child health indicators between urban and rural areas using seven data points provided by nationally representative population based surveys-the Malawi Demographic and Health Surveys and Multiple Indicator Cluster Surveys. Rate differences between urban and rural values for selected child health indicators were calculated to denote whether urban-rural differentials showed a trend of declining urban advantage in Malawi. The results show that all forms of child mortality have significantly declined between 1992 and 2015/2016 reflecting successes in child health interventions. Rural-urban comparisons, using rate differences, largely indicate a picture of the narrowing gap between urban and rural areas albeit the extent and pattern vary among child health indicators. Of the 13 child health indicators, eight (neonatal mortality, infant mortality, under-five mortality rates, stunting rate, proportion of children treated for diarrhea and fever, proportion of children sleeping under insecticide-treated nets, and children fully immunized at 12 months) show clear patterns of a declining urban advantage particularly up to 2014. However, U-5MR shows reversal to a significant urban advantage in 2015/2016, and slight increases in urban advantage are noted for infant mortality rate, underweight, full childhood immunization, and stunting rate in 2015/2016. Our findings suggest the need to rethink the policy viewpoint of a disadvantaged rural and much better-off urban in child health
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Cancino, Ramon S; Jack, Brian W; Jarvis, John; Cummings, Alice Kate; Cooper, Ellie; Cremieux, Pierre-Yves; Burgess, James F
2017-07-01
In 2011, fee-for-service patients with both Medicare and Medicaid (dual eligible) sustained $319.5 billion in health care costs. To describe the emergency department (ED) use and hospital admissions of adult dual eligible patients aged under 65 years who used an urban safety net hospital. This was a retrospective database analysis of patients aged between 18 and 65 years with Medicare and Medicaid, who used an urban safety net academic health center between January 1, 2011, and December 31, 2011. We compared patients with and without behavioral health illness. The main outcome measures were hospital admission and ED use. Chi-square and Wilcoxon rank-sum tests were used for descriptive statistics on categorical and continuous variables, respectively. Greedy propensity score matching was used to control for confounding factors. Rate ratios (RR) and 95% confidence intervals (CI) were determined after matching and after adjusting for those variables that remained significantly different after matching. In 2011, 10% of all fee-for-service dual eligible patients aged less than 65 years in Massachusetts were seen at Boston Medical Center. Data before propensity score matching showed significant differences in age, sex, race/ethnicity, marital status, education, employment, physical comorbidities, and Charlson Comorbidity Index score between patients with and without behavioral health illness. Analysis after propensity score matching found significant differences in sex, Hispanic race, and other education and employment status. Compared with patients without behavioral health illness, patients with behavioral health illness had a higher RR for hospital admissions (RR = 2.07; 95% CI = 1.81-2.38; P fee-for-service plan had significantly higher rates of hospital admission and ED use compared with dual eligible patients without behavioral health illness at the largest urban safety net medical center in New England. Safety net hospitals care for a large proportion of dual
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Synergies and trade-offs between energy-efficient urbanization and health
Ahmad, Sohail; Pachauri, Shonali; Creutzig, Felix
2017-11-01
Energy-efficient urbanization and public health pose major development challenges for India. While both issues are intensively studied, their interaction is not well understood. Here we explore the relationship between urban infrastructures, public health, and household-related emissions, identifying potential synergies and trade-offs of specific interventions by analyzing nationally representative household surveys from 2005 and 2012. Our analysis confirms previous characterizations of the environmental-health transition, but also points to an important role of energy use and urbanization as modifiers of this transition. We find that non-motorized transport may prove a sweet spot for development, as its use is associated with lower emissions and better public health in cities. Urbanization and improved access to basic services correlate with lower short-term morbidity (STM), such as fever, cough and diarrhea. Our analysis suggests that a 10% increase in urbanization from current levels and concurrent improvement in access to modern cooking and clean water could lower STM for 2.4 million people. This would be associated with a modest increase in electricity related emissions of 84 ktCO2e annually. Promoting energy-efficient mobility systems, for instance by a 10% increase in bicycling, could lower chronic conditions like diabetes and cardio-vascular diseases for 0.3 million people while also abating emissions. These findings provide empirical evidence to validate that energy-efficient and sustainable urbanization can address both public health and climate change challenges simultaneously.
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Directory of Open Access Journals (Sweden)
Jenny Roe
2016-07-01
Full Text Available Very little is known about how differences in use and perceptions of urban green space impact on the general health of black and minority ethnic (BME groups. BME groups in the UK suffer from poorer health and a wide range of environmental inequalities that include poorer access to urban green space and poorer quality of green space provision. This study used a household questionnaire (n = 523 to explore the relationship between general health and a range of individual, social and physical environmental predictors in deprived white British and BME groups living in ethnically diverse cities in England. Results from Chi-Squared Automatic Interaction Detection (CHAID segmentation analyses identified three distinct general health segments in our sample ranging from “very good” health (people of Indian origin, to ”good” health (white British, and ”poor” health (people of African-Caribbean, Bangladeshi, Pakistani origin and other BME groups, labelled ”Mixed BME” in the analyses. Correlated Component Regression analyses explored predictors of general health for each group. Common predictors of general health across all groups were age, disability, and levels of physical activity. However, social and environmental predictors of general health-including use and perceptions of urban green space-varied among the three groups. For white British people, social characteristics of place (i.e., place belonging, levels of neighbourhood trust, loneliness ranked most highly as predictors of general health, whilst the quality of, access to and the use of urban green space was a significant predictor of general health for the poorest health group only, i.e., in ”Mixed BME”. Results are discussed from the perspective of differences in use and perceptions of urban green space amongst ethnic groups. We conclude that health and recreation policy in the UK needs to give greater attention to the provision of local green space amongst poor BME
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Roe, Jenny; Aspinall, Peter A.; Ward Thompson, Catharine
2016-01-01
Very little is known about how differences in use and perceptions of urban green space impact on the general health of black and minority ethnic (BME) groups. BME groups in the UK suffer from poorer health and a wide range of environmental inequalities that include poorer access to urban green space and poorer quality of green space provision. This study used a household questionnaire (n = 523) to explore the relationship between general health and a range of individual, social and physical environmental predictors in deprived white British and BME groups living in ethnically diverse cities in England. Results from Chi-Squared Automatic Interaction Detection (CHAID) segmentation analyses identified three distinct general health segments in our sample ranging from “very good” health (people of Indian origin), to ”good” health (white British), and ”poor” health (people of African-Caribbean, Bangladeshi, Pakistani origin and other BME groups), labelled ”Mixed BME” in the analyses. Correlated Component Regression analyses explored predictors of general health for each group. Common predictors of general health across all groups were age, disability, and levels of physical activity. However, social and environmental predictors of general health-including use and perceptions of urban green space-varied among the three groups. For white British people, social characteristics of place (i.e., place belonging, levels of neighbourhood trust, loneliness) ranked most highly as predictors of general health, whilst the quality of, access to and the use of urban green space was a significant predictor of general health for the poorest health group only, i.e., in ”Mixed BME”. Results are discussed from the perspective of differences in use and perceptions of urban green space amongst ethnic groups. We conclude that health and recreation policy in the UK needs to give greater attention to the provision of local green space amongst poor BME communities since this
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Roe, Jenny; Aspinall, Peter A; Ward Thompson, Catharine
2016-07-05
Very little is known about how differences in use and perceptions of urban green space impact on the general health of black and minority ethnic (BME) groups. BME groups in the UK suffer from poorer health and a wide range of environmental inequalities that include poorer access to urban green space and poorer quality of green space provision. This study used a household questionnaire (n = 523) to explore the relationship between general health and a range of individual, social and physical environmental predictors in deprived white British and BME groups living in ethnically diverse cities in England. Results from Chi-Squared Automatic Interaction Detection (CHAID) segmentation analyses identified three distinct general health segments in our sample ranging from "very good" health (people of Indian origin), to "good" health (white British), and "poor" health (people of African-Caribbean, Bangladeshi, Pakistani origin and other BME groups), labelled "Mixed BME" in the analyses. Correlated Component Regression analyses explored predictors of general health for each group. Common predictors of general health across all groups were age, disability, and levels of physical activity. However, social and environmental predictors of general health-including use and perceptions of urban green space-varied among the three groups. For white British people, social characteristics of place (i.e., place belonging, levels of neighbourhood trust, loneliness) ranked most highly as predictors of general health, whilst the quality of, access to and the use of urban green space was a significant predictor of general health for the poorest health group only, i.e., in "Mixed BME". Results are discussed from the perspective of differences in use and perceptions of urban green space amongst ethnic groups. We conclude that health and recreation policy in the UK needs to give greater attention to the provision of local green space amongst poor BME communities since this can play an
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Rural-urban migration in Nigeria: consequences on housing, health-care and employment.
Johnnie, P B
1988-01-01
This article explores the results of an on-going longitudinal study in selected high-density areas of Port Harcourt metropolis involving 240 respondents from 4 groups. When respondents in the 1st cohort (watchnights, laborers, and messengers) were asked what motivated them to move from rural areas to the city, 94% said to get better jobs and increase their earnings. 98% of the clerks migrated to Port Harcourt for better jobs and to find employment. All 40 school leavers confirmed that they had moved to the city to find jobs. In spite of the various statutory provisions and policy statements relating to housing in Nigeria there still exists an acute and noticeable shortage both in rural and urban housing. There not only exists a dearth of residential accommodation in these urban centers, but there is also a seemingly atrocious disparity in housing conditions between a large majority of poor urban dwellers and a negligible number of urban residents who are reasonably wealthy. With the growing number of persons migrating from the rural areas to the urban centers, there are also likely to be problems of overcrowding which would exacerbate the problems of communicable diseases and pollution. In terms of the allocation of medical personnel, equipment, and drugs, there is a disproportionately skewed distribution in favor of urban dwellers. 1 important cause of urban employment problems is the phenomenal growth in urbanization and the inability of these urban centers to be able to utilize or absorb the urban labor that was created through the process of urbanization. The other problem is the extremely slow pace of industrialization as compared to urbanization . A serious malady responsible for urban unemployment is the staggering rate at which young school leavers migrate to the city. Nigeria as a nation state has assumed the most dangerous dimensions of capitalism by deliberately erecting inequality and poverty in society. 1 way by which the state, controlled by the
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Kang'ethe, E K; Grace, D; Randolph, T F
2007-11-01
To collate and synthesize current knowledge of components of urban agriculture (UA) with a thematic emphasis on human health impact and a geographic emphasis on East Africa. Data management followed a structured approach in which key issues were first identified and then studies selected through literature search and personal communication. Evidence-based principles. Urban agriculture is an important source of food security for urban dwellers in East Africa. Descriptors of UA are location, areas, activities, scale, products, destinations, stakeholders and motivation. Many zoonotic and food-borne diseases have been associated with UA but evidence on human health impact and management is lacking. Major constraints to UA are illegality and lack of access to input and market; policy options have been developed for overcoming these. Urban agriculture is an important activity and likely to remain so. Both positive and negative human health impacts are potentially important but more research is needed to understand these and set appropriate policy and support levels.
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Directory of Open Access Journals (Sweden)
Hamid Moradi
2011-03-01
Full Text Available Abstract Distribution of goods and services in cities is of utmost importance. Selecting appropriate venues for different service centers in a city not only enables the citizens to access these services much more easily, but also reduces the traffic load caused by trips made to reach them. Unfortunately, the lack of a correct urban planning has led to inappropriate formation of many cities around the world in terms of the locations assumed for different service centers. Since the private sector has been given the responsibility to construct most of these centers, changing their current locations may be restricted due to legal obligations. Therefore, it seems necessary for the government to construct new service centers with high competitive facilities to attract customers and to compete with those built by the private sector. In this paper, the selection of appropriate locations to construct new service centers has been studied. Such locations have been selected in a way to fulfill goals such as rapid and easy accessibility for the customers and reduction of traffic drawbacks caused by the related trips. In this regard, a model for service centers with restricted capacity has been designed and a parallel simulated annealing algorithm has been proposed to solve it. Finally, the proposed algorithm has been utilized to locate the health centers around the city of Isfahan and its efficiency has been investigated. The findings highlight the accuracy and speed of the proposed algorithm in location of the health centers of Isfahan.
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Mental Health Screening Center
... Releases & Announcements Public Service Announcements Partnering with DBSA Mental Health Screening Center These online screening tools are not ... you have any concerns, see your doctor or mental health professional. Depression Screening for Adult Depression Screening for ...
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Utilization of Mental Health Services in School-Based Health Centers
Bains, Ranbir M.; Cusson, Regina; White-Frese, Jesse; Walsh, Stephen
2017-01-01
Background: We summarize utilization patterns for mental health services in school-based health centers. Methods: Administrative data on school-based health center visits in New Haven, Connecticut were examined for the 2007-2009 school years. Relative frequencies of mental health visits by age were calculated as a percentage of all visits and were…
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Roldán, José; Álvarez, Marsela; Carrasco, María; Guarneros, Noé; Ledesma, José; Cuchillo-Hilario, Mario; Chávez, Adolfo
2017-12-01
Marginalization is a significant issue in Mexico, involving a lack of access to health services with differential impacts on Indigenous, rural and urban populations. The objective of this study was to understand Mexico’s public health problem across three population areas, Indigenous, rural and urban, in relation to degree of marginalization and health service coverage. The sampling universe of the study consisted of 107 458 geographic locations in the country. The study was retrospective, comparative and confirmatory. The study applied analysis of variance, parametric and non-parametric, correlation and correspondence analyses. Significant differences were identified between the Indigenous, rural and urban populations with respect to their level of marginalization and access to health services. The most affected area was Indigenous, followed by rural areas. The sector that was least affected was urban. Although health coverage is highly concentrated in urban areas in Mexico, shortages are mostly concentrated in rural areas where Indigenous groups represent the extreme end of marginalization and access to medical coverage. Inadequate access to health services in the Indigenous and rural populations throws the gravity of the public health problem into relief.
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Center for the Advancement of Health
... More Prepared Patient Blogs » WHAT IS PATIENT ENGAGEMENT? HEALTH BEHAVIOR NEWS Urban Parks and Trails Are Cost-Effective Ways to Promote Exercise December 8, 2014 Military Culture Enables Tobacco Use ...
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Pope, D; Katreniak, Z; Guha, J; Puzzolo, E; Higgerson, J; Steels, S; Woode-Owusu, M; Bruce, N; Birt, Christopher A; Ameijden, E van; Verma, A
2017-05-01
Measuring health and its determinants in urban populations is essential to effectively develop public health policies maximizing health gain within this context. Adolescents are important in this regard given the origins of leading causes of morbidity and mortality develop pre-adulthood. Comprehensive, accurate and comparable information on adolescent urban health indicators from heterogeneous urban contexts is an important challenge. EURO-URHIS 2 aimed to develop standardized tools and methodologies collecting data from adolescents across heterogenous European urban contexts. Questionnaires were developed including (i) comprehensive assessment of urban health indicators from 7 pre-defined domains, (ii) use of previously validated questions from a literature review and other European surveys, (iii) translation/back-translation into European languages and (iv) piloting. Urban area-specific data collection methodologies were established through literature review, consultation and piloting. School-based surveys of 14-16-year olds (400-800 per urban area) were conducted in 13 European countries (33 urban areas). Participation rates were high (80-100%) for students from schools taking part in the surveys from all urban areas, and data quality was generally good (low rates of missing/spoiled data). Overall, 13 850 questionnaires were collected, coded and entered for EURO-URHIS 2. Dissemination included production of urban area health profiles (allowing benchmarking for a number of important public health indicators in young people) and use of visualization tools as part of the EURO-URHIS 2 project. EURO-URHIS 2 has developed standardized survey tools and methodologies for assessing key measures of health and its determinants in adolescents from heterogenous urban contexts and demonstrated the utility of this data to public health practitioners and policy makers. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association
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Urbanization and health in China, thinking at the national, local and individual levels.
Li, Xinhu; Song, Jinchao; Lin, Tao; Dixon, Jane; Zhang, Guoqin; Ye, Hong
2016-03-08
China has the biggest population in the world, and has been experiencing the largest migration in history, and its rapid urbanization has profound and lasting impacts on local and national public health. Under these conditions, a systems understanding on the correlation among urbanization, environmental change and public health and to devise solutions at national, local and individual levels are in urgent need. In this paper, we provide a comprehensive review of recent studies which have examined the relationship between urbanization, urban environmental changes and human health in China. Based on the review, coupled with a systems understanding, we summarize the challenges and opportunities for promoting the health and wellbeing of the whole nation at national, local, and individual levels. Urbanization and urban expansion result in urban environmental changes, as well as residents' lifestyle change, which can lead independently and synergistically to human health problems. China has undergone an epidemiological transition, shifting from infectious to chronic diseases in a much shorter time frame than many other countries. Environmental risk factors, particularly air and water pollution, are a major contributing source of morbidity and mortality in China. Furthermore, aging population, food support system, and disparity of public service between the migrant worker and local residents are important contributions to China's urban health. At the national level, the central government could improve current environmental policies, food safety laws, and make adjustments to the health care system and to demographic policy. At the local level, local government could incorporate healthy life considerations in urban planning procedures, make improvements to the local food supply, and enforce environmental monitoring and management. At the individual level, urban residents can be exposed to education regarding health behaviour choices while being encouraged to take
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The Health Penalty of China's Rapid Urbanization
E. Van de Poel (Ellen); O.A. O'Donnell (Owen); E.K.A. van Doorslaer (Eddy)
2009-01-01
textabstractRapid urbanization could have positive and negative health effects, such that the net impact on population health is not obvious. It is, however, highly pertinent to the human welfare consequences of development. This paper uses community and individual level longitudinal data from the
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Bentley, Michael
2014-09-01
The environmental determinants of public health and social equity present many challenges to a sustainable urbanism-climate change, water shortages and oil dependency to name a few. There are many pathways from urban environments to human health. Numerous links have been described but some underlying mechanisms behind these relationships are less understood. Combining theory and methods is a way of understanding and explaining how the underlying structures of urban environments relate to public health and social equity. This paper proposes a model for an ecological public health, which can be used to explore these relationships. Four principles of an ecological public health-conviviality, equity, sustainability and global responsibility-are used to derive theoretical concepts that can inform ecological public health thinking, which, among other things, provides a way of exploring the underlying mechanisms that link urban environments to public health and social equity. Theories of more-than-human agency inform ways of living together (conviviality) in urban areas. Political ecology links the equity concerns about environmental and social justice. Resilience thinking offers a better way of coming to grips with sustainability. Integrating ecological ethics into public health considers the global consequences of local urban living and thus attends to global responsibility. This way of looking at the relationships between urban environments, public health and social equity answers the call to craft an ecological public health for the twenty-first century by re-imagining public health in a way that acknowledges humans as part of the ecosystem, not separate from it, though not central to it. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
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Su, Meirong; Chen, Chen; Lu, Weiwei; Liu, Gengyuan; Yang, Zhifeng; Chen, Bin
2013-06-01
Urban public health is an important global issue, and receives extensive attention. It is necessary to compare urban public health status among different cities, so that each city can define its own health patterns and limiting factors. The following assessment indicators were established to evaluate urban public health status: living conditions, physical health, education and culture, environmental quality, and social security. A weighted-sum model was used in combination with these indicators to compare the urban public health status in four cities—Beijing, New York, London, and Tokyo—using data for 2000-2009. Although the urban public health level of Beijing was lower than that of the other cities, it showed the greatest increase in this level over the study period. Different patterns of urban public health were identified: London had the most balanced, steady pattern (almost all factors performed well and developed stably); New York and Tokyo showed balanced, but unsteady patterns (most factors remained high, though social security and environmental quality fluctuated); Beijing had the most unbalanced, unsteady pattern (the different factors were at different levels, and education and culture and social security fluctuated). For enhanced urban public health status, environmental quality and education and culture clearly need to be improved in Beijing. This study demonstrates that a comparison of different cities is helpful in identifying limiting factors for urban public health and providing an orientation for future urban development.
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Sun, Xiaojie; Zhang, Nan; Liu, Kun; Li, Wen; Oksanen, Tuula; Shi, Lizheng
2014-01-01
To examine whether workplace social capital improved after implementing a workplace social capital intervention in community health centers in China. This study was conducted in 20 community health centers of similar size in Jinan of China during 2012-2013. Using the stratified site randomization, 10 centers were randomized into the intervention group; one center was excluded due to leadership change in final analyses. The baseline survey including 447 staff (response rate: 93.1%) was conducted in 2012, and followed by a six-month workplace social capital intervention, including team building courses for directors of community health centers, voluntarily public services, group psychological consultation, and outdoor training. The follow-up survey in July 2013 was responded to by 390 staff members (response rate: 86.9%). Workplace social capital was assessed with the translated and culturally adapted scale, divided into vertical and horizontal dimensions. The facility-level intervention effects were based on all baseline (n = 427) and follow-up (n = 377) respondents, except for Weibei respondents. We conducted a bivariate Difference-in-Difference analysis to estimate the facility-level intervention effects. No statistically significant intervention effects were observed at the center level; the intervention increased the facility-level workplace social capital, and its horizontal and vertical dimensions by 1.0 (p = 0.24), 0.4 (p = 0.46) and 0.8 (p = 0.16), respectively. The comprehensive intervention seemed to slightly improve workplace social capital in community health centers of urban China at the center level. High attrition rate limits any causal interpretation of the results. Further studies are warranted to test these findings.
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Medical Waste Management in Community Health Centers.
Tabrizi, Jafar Sadegh; Rezapour, Ramin; Saadati, Mohammad; Seifi, Samira; Amini, Behnam; Varmazyar, Farahnaz
2018-02-01
Non-standard management of medical waste leads to irreparable side effects. This issue is of double importance in health care centers in a city which are the most extensive system for providing Primary Health Care (PHC) across Iran cities. This study investigated the medical waste management standards observation in Tabriz community health care centers, northwestern Iran. In this triangulated cross-sectional study (qualitative-quantitative), data collecting tool was a valid checklist of waste management process developed based on Iranian medical waste management standards. The data were collected in 2015 through process observation and interviews with the health center's staff. The average rate of waste management standards observance in Tabriz community health centers, Tabriz, Iran was 29.8%. This case was 22.8% in dimension of management and training, 27.3% in separating and collecting, 31.2% in transport and temporary storage, and 42.9% in sterilization and disposal. Lack of principal separation of wastes, inappropriate collecting and disposal cycle of waste and disregarding safety tips (fertilizer device performance monitoring, microbial cultures and so on) were among the observed defects in health care centers supported by quantitative data. Medical waste management was not in a desirable situation in Tabriz community health centers. The expansion of community health centers in different regions and non-observance of standards could predispose to incidence the risks resulted from medical wastes. So it is necessary to adopt appropriate policies to promote waste management situation.
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Mehdipanah, Roshanak; Manzano, Ana; Borrell, Carme; Malmusi, Davide; Rodriguez-Sanz, Maica; Greenhalgh, Joanne; Muntaner, Carles; Pawson, Ray
2015-01-01
Urban populations are growing and to accommodate these numbers, cities are becoming more involved in urban renewal programs to improve the physical, social and economic conditions in different areas. This paper explores some of the complexities surrounding the link between urban renewal, health and health inequalities using a theory-driven approach. We focus on an urban renewal initiative implemented in Barcelona, the Neighbourhoods Law, targeting Barcelona's (Spain) most deprived neighbourhoods. We present evidence from two studies on the health evaluation of the Neighbourhoods Law, while drawing from recent urban renewal literature, to follow a four-step process to develop a program theory. We then use two specific urban renewal interventions, the construction of a large central plaza and the repair of streets and sidewalks, to further examine this link. In order for urban renewal programs to affect health and health inequality, neighbours must use and adapt to the changes produced by the intervention. However, there exist barriers that can result in negative outcomes including factors such as accessibility, safety and security. This paper provides a different perspective to the field that is largely dominated by traditional quantitative studies that are not always able to address the complexities such interventions provide. Furthermore, the framework and discussions serve as a guide for future research, policy development and evaluation. Copyright © 2014 Elsevier Ltd. All rights reserved.
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The urban built environment and associations with women's psychosocial health.
Messer, Lynne C; Maxson, Pamela; Miranda, Marie Lynn
2013-10-01
The determinants that underlie a healthy or unhealthy pregnancy are complex and not well understood. We assess the relationship between the built environment and maternal psychosocial status using directly observed residential neighborhood characteristics (housing damage, property disorder, tenure status, vacancy, security measures, violent crime, and nuisances) and a wide range of psychosocial attributes (interpersonal support evaluation list, self-efficacy, John Henryism active coping, negative partner support, Perceived Stress Scale, perceived racism, Center for Epidemiologic Studies-Depression) on a pregnant cohort of women living in the urban core of Durham, NC, USA. We found some associations between built environment characteristic and psychosocial health varied by exposure categorization approach, while others (residence in environments with more rental property is associated with higher reported active coping and negative partner support) were consistent across exposure categorizations. This study outlines specific neighborhood characteristics that are modifiable risk markers and therefore important targets for increased research and public health intervention.
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Child health inequities in developing countries: differences across urban and rural areas.
Fotso, Jean-Christophe
2006-07-11
To document and compare the magnitude of inequities in child malnutrition across urban and rural areas, and to investigate the extent to which within-urban disparities in child malnutrition are accounted for by the characteristics of communities, households and individuals. The most recent data sets available from the Demographic and Health Surveys (DHS) of 15 countries in sub-Saharan Africa (SSA) are used. The selection criteria were set to ensure that the number of countries, their geographical spread across Western/Central and Eastern/Southern Africa, and their socioeconomic diversities, constitute a good yardstick for the region and allow us to draw some generalizations. A household wealth index is constructed in each country and area (urban, rural), and the odds ratio between its uppermost and lowermost category, derived from multilevel logistic models, is used as a measure of socioeconomic inequalities. Control variables include mother's and father's education, community socioeconomic status (SES) designed to represent the broad socio-economic ecology of the neighborhoods in which families live, and relevant mother- and child-level covariates. Across countries in SSA, though socioeconomic inequalities in stunting do exist in both urban and rural areas, they are significantly larger in urban areas. Intra-urban differences in child malnutrition are larger than overall urban-rural differentials in child malnutrition, and there seem to be no visible relationships between within-urban inequities in child health on the one hand, and urban population growth, urban malnutrition, or overall rural-urban differentials in malnutrition, on the other. Finally, maternal and father's education, community SES and other measurable covariates at the mother and child levels only explain a slight part of the within-urban differences in child malnutrition. The urban advantage in health masks enormous disparities between the poor and the non-poor in urban areas of SSA. Specific
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Children's Aid Society, 2012
2012-01-01
School Based Health Centers (SBHC) are considered by experts as one of the most effective and efficient ways to provide preventive health care to children. Few programs are as successful in delivering health care to children at no cost to the patient, and where they are: in school. For many underserved children, The Children's Aid Society's…
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Directory of Open Access Journals (Sweden)
Raman Chauhan
2016-01-01
Full Text Available Introduction: The health planners in India have visualized primary health centers (PHCs and community health centers (CHCs as the key healthcare delivery institutions in rural areas. These centers are supposed to have health manpower, infrastructure, and service delivery as per the Indian public health standards (IPHS guidelines (2010. Materials and Methods: A cross-sectional study was conducted in seven CHCs and 12 PHCs, randomly selected from eight blocks of Shimla District and evaluated in terms of health manpower, infrastructure, and services from September 2011 to August 2012. Data was collected from the selected units using structured data collection instruments designed by the IPHS. Results: The health centers were assessed according to IPHS guidelines. Outpatient department services and referral services were provided in all the centers studied. No specialist doctor was posted at any of CHCs against a sanctioned strength of at least four (surgeon, physician, obstetrician, and pediatrician per CHC. In 3 (42.8% CHCs and 8 (75% PHCs, no pharmacist was posted. Eight (75% PHCs did not have any staff nurse posted. Three (42.8% CHCs and 10 (83.3% PHCs did not have a laboratory technician. In CHCs, separate labor room was available in 6 (85.7% whereas a separate laboratory was available in all seven. Separate labor room and laboratory were available in four (25% PHCs. Conclusions: IPHS guidelines are not being followed at PHC and CHC levels of the district. Health manpower shortage is the key bottleneck in service delivery. Political advocacy is needed to ensure sufficient health manpower availability to deliver quality healthcare.
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Nature-Based Strategies for Improving Urban Health and Safety.
Kondo, Michelle C; South, Eugenia C; Branas, Charles C
2015-10-01
Place-based programs are being noticed as key opportunities to prevent disease and promote public health and safety for populations at-large. As one key type of place-based intervention, nature-based and green space strategies can play an especially large role in improving health and safety for dwellers in urban environments such as US legacy cities that lack nature and greenery. In this paper, we describe the current understanding of place-based influences on public health and safety. We focus on nonchemical environmental factors, many of which are related to urban abandonment and blight. We then review findings from studies of nature-based interventions regarding impacts on health, perceptions of safety, and crime. Based on our findings, we suggest that further research in this area will require (1) refined measures of green space, nature, and health and safety for cities, (2) interdisciplinary science and cross-sector policy collaboration, (3) observational studies as well as randomized controlled experiments and natural experiments using appropriate spatial counterfactuals and mixed methods, and (4) return-on-investment calculations of potential economic, social, and health costs and benefits of urban greening initiatives.
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Implementing health management information systems: measuring success in Korea's health centers.
Chae, Y M; Kim, S I; Lee, B H; Choi, S H; Kim, I S
1994-01-01
This article analyses the effects that the introduction and adoption of a health management information system (HMIS) can have on both the productivity of health center staff as well as on user-satisfaction. The focus is upon the service provided by the Kwonsun Health Center located in Suwon City, Korea. Two surveys were conducted to measure the changes in productivity and adoption (knowledge, persuasion, decision, implementation and confirmation) of health center staff over time. In addition, a third survey was conducted to measure the effects of HMIS on the level of satisfaction perceived by the visitors, by comparing the satisfaction level between the study health center and a similar health center identified as a control. The results suggest that HMIS increased the productivity and satisfaction of the staff but did not increase their persuasion and decision levels; and, that is also succeeded in increasing the levels of visitors' satisfaction with the services provided.
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Shopping centers as attractive spaces for urban mobility. The case of the Community of Madrid
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Cristina López García de Leániz
2017-08-01
Full Text Available Malls have become important focal points of trips in the outskirts of major urban conurbations. These trips take place predominantly in private vehicles, this compromising the objectives of sustainable mobility policies set by most of the metropolis. This article aims at characterizing the mobility patterns attracted by shopping malls within the Madrid metropolitan area. It is based on surveys carried out in eleven large commercial centers. Its departing hypothesis underlines that the location of shopping centers largely determines its incoming travel patterns. Therefore, from the standpoint of public policy, solutions should be addressed more from the perspective of urban planning that from the improvement of infrastructure and transport services.
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Health Care and Aboriginal Seniors in Urban Canada: Helping a Neglected Class
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Loleen Berdahl
2011-05-01
Full Text Available Canadian researchers and policymakers have paid limited attention to the health care needs of Aboriginal seniors. This lack of attention is problematic, as the situation of Aboriginal seniors – including both status and non-status First Nations, Métis and Inuit – is particularly bleak. Using Winnipeg, Regina and Saskatoon as examples, this paper analyses the health care challenges facing Aboriginal seniors in urban Canada. We ask, what policy approaches are needed to improve the health and wellbeing of urban Aboriginal seniors so that they can have good quality living reflective of their needs and culture? We suggest that, in thinking throughpresent and future health services for urban Aboriginal seniors, policymakers should consider four key factors: socioeconomic conditions; underutilization of urban health services; jurisdiction; and elder abuse.
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A comparison of health inequalities in urban and rural Scotland.
Levin, Kate A; Leyland, Alastair H
2006-03-01
Previous research suggests that there are significant differences in health between urban and rural areas. Health inequalities between the deprived and affluent in Scotland have been rising over time. The aim of this study was to examine health inequalities between deprived and affluent areas of Scotland for differing ruralities and look at how these have changed over time. Postcode sectors in Scotland were ranked by deprivation and the 20% most affluent and 20% most deprived areas were found using the Carstairs indicator and male unemployment. Scotland was then split into 4 rurality types. Ratios of health status between the most deprived and most affluent areas were investigated using all cause mortality for the Scottish population, 1979-2001. These were calculated over time for 1979-1983, 1989-1993, 1998-2001. Multilevel Poisson modelling was carried out for all of Scotland excluding Grampian to assess inequalities in the population. There was an increase in inequalities between 1981 and 2001, which was greatest in remote rural Scotland for both males and females; however, male health inequalities remained higher in urban areas throughout this period. In 2001 female health inequalities were higher in remote rural areas than urban areas. Health inequalities amongst the elderly (age 65+) in 2001 were greater in remote rural Scotland than urban areas for both males and females.
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Clinical quality performance in U.S. health centers.
Shi, Leiyu; Lebrun, Lydie A; Zhu, Jinsheng; Hayashi, Arthur S; Sharma, Ravi; Daly, Charles A; Sripipatana, Alek; Ngo-Metzger, Quyen
2012-12-01
To describe current clinical quality among the nation's community health centers and to examine health center characteristics associated with performance excellence. National data from the 2009 Uniform Data System. Health centers reviewed patient records and reported aggregate data to the Uniform Data System. Six measures were examined: first-trimester prenatal care, childhood immunization completion, Pap tests, low birth weight, controlled hypertension, and controlled diabetes. The top 25 percent performing centers were compared with lower performing (bottom 75 percent) centers on these measures. Logistic regressions were utilized to assess the impact of patient, provider, and institutional characteristics on health center performance. Clinical care and outcomes among health centers were generally comparable to national averages. For instance, 67 percent of pregnant patients received timely prenatal care (national = 68 percent), 69 percent of children achieved immunization completion (national = 67 percent), and 63 percent of hypertensive patients had blood pressure under control (national = 48 percent). Depending on the measure, centers with more uninsured patients were less likely to do well, while centers with more physicians and enabling service providers were more likely to do well. Health centers provide quality care at rates comparable to national averages. Performance may be improved by increasing insurance coverage among patients and increasing the ratios of physicians and enabling service providers to patients. © Health Research and Educational Trust.
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(UnHealthy in the City: Respiratory, Cardiometabolic and Mental Health Associated with Urbanity.
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Wilma L Zijlema
Full Text Available Research has shown that health differences exist between urban and rural areas. Most studies conducted, however, have focused on single health outcomes and have not assessed to what extent the association of urbanity with health is explained by population composition or socioeconomic status of the area. Our aim is to investigate associations of urbanity with four different health outcomes (i.e. lung function, metabolic syndrome, depression and anxiety and to assess whether these associations are independent of residents' characteristics and area socioeconomic status.Our study population consisted of 74,733 individuals (42% males, mean age 43.8 who were part of the baseline sample of the LifeLines Cohort Study. Health outcomes were objectively measured with spirometry, a physical examination, laboratory blood analyses, and a psychiatric interview. Using multilevel linear and logistic regression models, associations of urbanity with lung function, and prevalence of metabolic syndrome, major depressive disorder and generalized anxiety disorder were assessed. All models were sequentially adjusted for age, sex, highest education, household equivalent income, smoking, physical activity, and mean neighborhood income.As compared with individuals living in rural areas, those in semi-urban or urban areas had a poorer lung function (β -1.62, 95% CI -2.07;-1.16, and higher prevalence of major depressive disorder (OR 1.65, 95% CI 1.35;2.00, and generalized anxiety disorder (OR 1.58, 95% CI 1.35;1.84. Prevalence of metabolic syndrome, however, was lower in urban areas (OR 0.51, 95% CI 0.44;0.59. These associations were only partly explained by differences in residents' demographic, socioeconomic and lifestyle characteristics and socioeconomic status of the areas.Our results suggest a differential health impact of urbanity according to type of disease. Living in an urban environment appears to be beneficial for cardiometabolic health but to have a detrimental
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Directory of Open Access Journals (Sweden)
Kolesnikov Sergey Anatol’evich
2015-01-01
Full Text Available This article presents some results of the author’s dissertation research dedicated to formation of an architectural typology of high urbanized multifunctional units of urban structure of the largest cities (further HUMUUS as centers of social activity, which include buildings, constructions, transportation equipment and open spaces, where human flows transpose, start and end with the purpose of bringing into this space a concentrated maximum of goods, services and information with minimum time expenditures. This article draws attention to the development analysis of the structure-forming functions of HUMUUS and their town planning and environmental impact on the surrounding area. The study of planning structures of the largest Russian cities (Samara, Kazan, Nizhny Novgorod made it possible to identify a number of main objects, in which structure-forming functions of HUMUUS are materialized: railroad complex (historically formed, developed, dominated, system-wide road junction, transport interchange hub (providing intraurban messages, public office and business centers, leisure and entertainment centers, shopping centers. Basing on researches of Russian and foreign experience, it is possible to predict with full confidence the following trends and streams of environmental and urban development of HUMUUS in the near-term perspective: Strengthening of the environmental and urban frame by network evolution of HUMUUS; Inclusion of green areas of HUMUUS in the system of citywide green areas; Increment of the interest of the investors to the public road junction for the purpose of reorganization of them to full HUMUUS with all characteristics of high-urbanized and environmental and urban reorganization (separation of traffic and pedestrian flows, maximum capacity, multiple-level system, multifunctional, increase in landscaped green space, reconstruction of engineering systems and communications, the use of modern ecological building designs and
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The Urban Teaching Cohort: Pre-Service Training to Support Mental Health in Urban Schools
Schwartz, Tammy; Dinnen, Hannah; Smith-Millman, Marissa K.; Dixon, Maressa; Flaspohler, Paul D.
2017-01-01
Supporting students' mental health needs is critical in high-poverty urban school districts where many students are at risk for mental health problems. Although teacher-student relationships are at the core of student mental health promotion in the classroom, many teacher preparation programmes do not adequately prepare pre-service teachers…
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Academic Medical Centers as digital health catalysts.
DePasse, Jacqueline W; Chen, Connie E; Sawyer, Aenor; Jethwani, Kamal; Sim, Ida
2014-09-01
Emerging digital technologies offer enormous potential to improve quality, reduce cost, and increase patient-centeredness in healthcare. Academic Medical Centers (AMCs) play a key role in advancing medical care through cutting-edge medical research, yet traditional models for invention, validation and commercialization at AMCs have been designed around biomedical initiatives, and are less well suited for new digital health technologies. Recently, two large bi-coastal Academic Medical Centers, the University of California, San Francisco (UCSF) through the Center for Digital Health Innovation (CDHI) and Partners Healthcare through the Center for Connected Health (CCH) have launched centers focused on digital health innovation. These centers show great promise but are also subject to significant financial, organizational, and visionary challenges. We explore these AMC initiatives, which share the following characteristics: a focus on academic research methodology; integration of digital technology in educational programming; evolving models to support "clinician innovators"; strategic academic-industry collaboration and emergence of novel revenue models. Copyright © 2014 Elsevier Inc. All rights reserved.
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Rural-Urban Disparities in Health and Health Care in Africa: Cultural ...
African Journals Online (AJOL)
Rural-Urban Disparities in Health and Health Care in Africa: Cultural Competence, Lay-beliefs in Narratives of Diabetes among the Rural Poor in the Eastern Cape ... to exist in the utilization of cardiac diagnostic and therapeutic procedures, prescription of analgesia for pains, treatment of diabetes (e.g. gym exercise).
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Lv, Jinxia; Jiang, Weiguo
2017-04-01
With the economic development and technological innovation, urban planning and construction has already broken through the shackles of the natural conditions such as topography and geomorphology, and the social factors such as politics and location have been affected by the urbanization process in the process of urbanization. At the same time, the synergies between urban development and local economy, national policy, industrial distribution and so on are also paid more attention. As the third pole of Chinese economy after the Pearl River Delta and the Yangtze River Delta, the Beijing-Tianjin-Hebei Metropolis Circle has attracted extensive attention on experts and scholars in its urban development and location. In recent years, studies on urban development have not only analyzed the spatial characteristics of urban or urban agglomerations, but also discussed the relationship between urban development and certain elements or phenomena. This paper presents a multi-threshold and multi-feature extraction method for building land using the optical characteristics of different landforms, based on Landsat remote sensing images from 1984 to 2016. The method selected Automated Water Extraction Index (AWEI), Normalized Difference Vegetation Index (NDVI), Soil Extraction Index (SOEI) and Normalized Difference Built-up Index (BUEI) to extract the construction land. It is an example study area of Beijing to extract the construction land in 30 years and to do a examine research. Using the ArcGIS software to calculate, we can get the coordinates of the city center of gravity in Beijing in various years. It can be seen that the center of gravity of built-up area and the movement of the center of gravity in Beijing. The results showed that the construction land in Beijing has an increasing tendency in recent 30 years. The main characteristic of expansion is the way of high-speed outward development. From 1984 to 1999, the center of gravity of the city shifted to the northeast, and
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Directory of Open Access Journals (Sweden)
Carlos Castillo-Salgado
2015-11-01
Full Text Available Abstract Health observatories may differ according to their mission, institutional setting, topical emphasis or geographic coverage. This paper discusses the development of a new urban-focused health observatory, and its operational research and training infrastructure under the academic umbrella of the Department of Epidemiology and the Institute of Urban Health at the Johns Hopkins Bloomberg School of Public Health (BSPH in Baltimore, USA. Recognizing the higher education mission of the BSPH, the development of a new professional training in public health was an important first step for the development of this observatory. This new academia-based observatory is an innovative public health research and training platform offering faculty, investigators, professional epidemiology students and research partners a physical and methodological infrastructure for their operational research and training activities with both a local urban focus and a global reach. The concept of a public health observatory and its role in addressing social health inequalities in local urban settings is discussed.
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Castillo-Salgado, Carlos
2015-11-01
Health observatories may differ according to their mission, institutional setting, topical emphasis or geographic coverage. This paper discusses the development of a new urban-focused health observatory, and its operational research and training infrastructure under the academic umbrella of the Department of Epidemiology and the Institute of Urban Health at the Johns Hopkins Bloomberg School of Public Health (BSPH) in Baltimore, USA. Recognizing the higher education mission of the BSPH, the development of a new professional training in public health was an important first step for the development of this observatory. This new academia-based observatory is an innovative public health research and training platform offering faculty, investigators, professional epidemiology students and research partners a physical and methodological infrastructure for their operational research and training activities with both a local urban focus and a global reach. The concept of a public health observatory and its role in addressing social health inequalities in local urban settings is discussed.
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Marketing and Community Mental Health Centers.
Ferniany, Isaac W.; Garove, William E.
1983-01-01
Suggests that a marketing approach can be applied to community mental health centers. Marketing is a management orientation of providing services for, not to, patients in a systematic manner, which can help mental health centers improve services, strengthen community image, achieve financial independence and aid in staff recruitment. (Author)
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Child health inequities in developing countries: differences across urban and rural areas
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Fotso Jean-Christophe
2006-07-01
Full Text Available Abstract Objectives To document and compare the magnitude of inequities in child malnutrition across urban and rural areas, and to investigate the extent to which within-urban disparities in child malnutrition are accounted for by the characteristics of communities, households and individuals. Methods The most recent data sets available from the Demographic and Health Surveys (DHS of 15 countries in sub-Saharan Africa (SSA are used. The selection criteria were set to ensure that the number of countries, their geographical spread across Western/Central and Eastern/Southern Africa, and their socioeconomic diversities, constitute a good yardstick for the region and allow us to draw some generalizations. A household wealth index is constructed in each country and area (urban, rural, and the odds ratio between its uppermost and lowermost category, derived from multilevel logistic models, is used as a measure of socioeconomic inequalities. Control variables include mother's and father's education, community socioeconomic status (SES designed to represent the broad socio-economic ecology of the neighborhoods in which families live, and relevant mother- and child-level covariates. Results Across countries in SSA, though socioeconomic inequalities in stunting do exist in both urban and rural areas, they are significantly larger in urban areas. Intra-urban differences in child malnutrition are larger than overall urban-rural differentials in child malnutrition, and there seem to be no visible relationships between within-urban inequities in child health on the one hand, and urban population growth, urban malnutrition, or overall rural-urban differentials in malnutrition, on the other. Finally, maternal and father's education, community SES and other measurable covariates at the mother and child levels only explain a slight part of the within-urban differences in child malnutrition. Conclusion The urban advantage in health masks enormous disparities
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Lai, Karen; Guo, Sisi; Ijadi-Maghsoodi, Roya; Puffer, Maryjane; Kataoka, Sheryl H.
2016-01-01
Objective School-based health centers (SBHCs) reduce mental health access-to-care barriers and improve educational outcomes for youth. This qualitative study evaluates the innovations and challenges of a unique network of SBHCs in a large, urban school district, as they attempt to integrate health, mental health, and educational services. Methods The 43 participants sampled included mental health providers, primary care providers, and care coordinators at 14 SBHCs. Semi-structured interviews with each participant were audio-recorded and transcribed. Themes were identified and coded using Atlas.ti 5.1, and collapsed into three domains: Operations, Partnership, and Engagement. Results Interviews revealed provider models ranging from single agencies offering both health and mental health services to co-located services. Sites with the Health Agency providing at least some mental health services reported more mental health screenings. Many sites utilized SBHC coordinators and coordination team meetings to facilitate relationships between schools and Health Agency and Community Mental Health Clinic providers. Partnership challenges included confidentiality policies and staff turnover. Participants also highlighted student and parent engagement, through culturally sensitive services, peer health advocates, and “drop-in” lunches. Conclusions Staffing and operational models are critical in the success of health-mental health-education integration. Among the provider models observed, the combined health and mental health provider model offered the most integrated services. Despite barriers, providers and schools have begun to implement novel solutions for operational problems and family engagement in mental health services. Implications for future SBHCs as an integrated model are described. PMID:27417895
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Introduction--Knowledge translation and urban health equity: advancing the agenda.
Murphy, Kelly; Fafard, Patrick; O'Campo, Patricia
2012-12-01
In 2011, an interdisciplinary symposium was organized in Toronto, Canada to investigate prevailing models of health policy change in the knowledge translation literature and to assess the applicability of these models for equity-focused urban health research. The papers resulting from the symposium have been published together, in the Journal of Urban Health, along with this introductory essay. This essay describes how the different papers grapple in different ways with how to understand and to bridge the gaps between urban health research and action. The breadth of perspectives reflected in the papers (e.g., social epidemiology, public health, political science, sociology, critical labor studies, and educational psychology) shed much light on core tensions in the relationship between KT and health equity. The first tension is whether the content of evidence or the context of decision making is the strong determinate of research impact in relation to health equity policy. The second tension is whether relationships between health equity researchers and decision makers are best viewed in terms of collaboration or of conflict. The third concerns the role that power plays in evidence-based policy making, when the issues at stake are not only empirical but also normative.
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Directory of Open Access Journals (Sweden)
Salma B. Galal
2014-06-01
Conclusion: Urban families have less health complaints than rural; however, rural families recover sooner. Families bypass often public primary health care services. Urban families overuse outpatient clinics in public hospitals.
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Levitt, L I; Brownlee, W H; Lewars, M H
1968-12-01
A continuing consultative relationship between a general hospital department of psychiatry and an urban welfare center serving the residents of a privately owned hotel is described-the relationship is based on biweekly seminars. Individual case study is the method of training, and an activity program the vehicle for development of indigenous resident leadership. Problems in residents' relationship to their community, worker-resident relationships, resistances of residents, anticipating both workers and residents' readiness to assume responsibility, and defining the role of consultant were confronted. The project demonstrates the effectiveness of the technique, pointing up the need for refinement of the process and the development of tools for measurement.
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[Effectiveness of support for asbestos health consultation in health centers].
Nagamatsu, Yasuko
2011-09-01
In this research, we aimed to evaluate the support for asbestos health consultation in health centers. In this exploratory descriptive study, a self-administered original questionnaire was developed and used. Among all 517 health centers, valid responses were returned from 323 (62.5%) consenting centers. Consultations in the previous year ranged from 0-108 cases, with a facility median of 3.0 cases. Among staff members, 86.4% did not receive training and 35.4% had never used the manual. Workplaces that use asbestos within their jurisdiction were recognized by 39.2% of staff members, and 16.7% of these members always supported consultants psychologically. The staff members were not confident about asbestos health consultation: 71.2% for general questions, 76.2% for questions about asbestos-related diseases, and 76.4% for questions about risk of asbestos-related diseases; 51.4% were not confident about the Asbestos-Related Health Damage Relief System. Health center staff members who were significantly more confident were those who had more staff to work with; dealt with many consultations in the previous year; recognized the workplaces using asbestos within their jurisdiction; often used the manual and often psychologically supported consultants. According to the covariance structure analysis model, the 'use of support systems' consisting of 'the use of manual', 'training attendance' and 'recognition of workplaces that use asbestos' positively affected the frequency of psychological support (peffective in building the confidence of health center staff in relation to asbestos health consultation, although the use of these support systems was low.
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Differences in health care seeking behaviour between rural and urban communities in South Africa
2012-01-01
Objective The aim of this study was to explore possible differences in health care seeking behaviour among a rural and urban African population. Design A cross sectional design was followed using the infrastructure of the PURE-SA study. Four rural and urban Setswana communities which represented different strata of urbanisation in the North West Province, South Africa, were selected. Structured interviews were held with 206 participants. Data on general demographic and socio-economic characteristics, health status, beliefs about health and (access to) health care was collected. Results The results clearly illustrated differences in socio-economic characteristics, health status, beliefs about health, and health care utilisation. In general, inhabitants of urban communities rated their health significantly better than rural participants. Although most urban and rural participants consider their access to health care as sufficient, they still experienced difficulties in receiving the requested care. The difference in employment rate between urban and rural communities in this study indicated that participants of urban communities were more likely to be employed. Consequently, participants from rural communities had a significantly lower available weekly budget, not only for health care itself, but also for transport to the health care facility. Urban participants were more than 5 times more likely to prefer a medical doctor in private practice (OR:5.29, 95% CI 2.83-988). Conclusion Recommendations are formulated for infrastructure investments in rural communities, quality of health care and its perception, improvement of household socio-economical status and further research on the consequences of delay in health care seeking behaviour. PMID:22691443
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Page, Stacey A; Mbadiwe, Chinyere; McMorland, D Gordon; Grod, Jaroslaw P
2015-01-01
This study describes the opinions and behaviors of chiropractic patients in a large, western Canadian urban center regarding the sale of health products by doctors of chiropractic. A brief, descriptive survey consisting of both fixed-choice and open-ended questions was distributed by clinic reception staff at 4 chiropractic offices in Calgary, Alberta, Canada. Each practice sold a range of health products, including those relating to musculoskeletal care and nutrition, and served between 275 and 320 clients per week. After a 10-week recruitment interval between January and March 2013, a convenience sample of 103 chiropractic patients was obtained. Most patients supported the sale of health products by doctors of chiropractic (n = 101; 98.1%), and most had made health product purchases from a doctor of chiropractic at some point (n = 73; 70.9%). Products relating to muscular care, exercise/rehabilitation products, and pillows were purchased most often (>40%). Consumers were most supportive of doctors of chiropractic selling products they perceived to be directly related to musculoskeletal care. Some participants believed that there should be limits placed on the range of products sold including the products had to be consistent with the practitioner's area of expertise and had to have some demonstrated level of effectiveness. Primary reasons for health product purchase included the doctor's recommendations, convenience, and perception that the product would improve well-being (>50%). This study found that chiropractic patients were supportive of health product sales by doctors of chiropractic, assuming certain conditions were met. Consumers believed that product sales should be undertaken with integrity and should be consistent with the doctor's area of expertise. Consumer beliefs appeared to impact their purchasing behaviors. Copyright © 2015 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.
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[Health centers: history and future prospects.].
Colin, Marie-Pierre; Acker, Dominique
2009-03-29
Health houses and health centers are often hailed as specifically modern forms of medical practice in mobile healthcare provision. Yet the concept of health center emerged in the seventeenth century. The founding principles of these institutions were to promote access to good-quality universal healthcare and to practice a form of healthcare that treated patients in their globality (i.e. within their social and environmental context) based on public healthcare measures. Though they constitute a response to a specific healthcare project, healthcare centers face a number of specific difficulties that pose a challenge to their durability and development. Payment per consultation is ill-adapted to the remuneration of their services, and methods of remuneration that may be applicable to independent medical practitioners do not apply in the context of health centers, which may struggle to survive without the support of territorial collectivities (i.e. regional and local authorities) or associations. Health houses face similar difficulties in terms of their structural expenses. Expectations are high for trying out new methods of remuneration. The perspective and experience of healthcare centers will likely prove to be essential in this context. Their future needs to be envisaged alongside health houses and medical hubs. The growth of precarity and the increasing difficulties affecting access to healthcare provision need to be taken into account. The choice of the specific type of structure will depend on local realities, on the political will of regional authorities and on the specific projects of healthcare professionals. Yet whatever solution is envisaged, it will not be possible without public funding.
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Adolescent use of school-based health centers and high school dropout.
Kerns, Suzanne E U; Pullmann, Michael D; Walker, Sarah Cusworth; Lyon, Aaron R; Cosgrove, T J; Bruns, Eric J
2011-07-01
To determine the association between use of school-based health centers (SBHCs) and school dropout. Quasi-experimental longitudinal analysis of a retrospective student cohort, with SBHC use as the independent variable. We statistically controlled for dropout risk and used propensity score regression adjustment to control for several factors associated with SBHC use. Integrated database from an urban public school district (academic outcomes) and department of public health (SBHC use). District-enrolled students in their first semester of ninth grade in 2005 (N = 3334), followed up through their anticipated on-time graduation semester of 12th grade in 2009. Students were divided into 4 groups: never used (47%); low use (23%); moderate use (20%); and high users (10%). Time to nongraduation (described as dropout). Low to moderate SBHC use (0.125-2.5 visits per semester) was associated with a 33% reduction in dropout compared with non-SBHC users. The high-use group (>2.5 visits per semester) did not have dropout rates that differed from nonusers. For SBHC users who did drop out, dropout occurred approximately 1 semester later than nonusers. Exploratory analyses revealed that the association between SBHC use and prevention of dropout was greatest for higher-risk students. This study found an association between low to moderate SBHC use and reductions in dropout for high school students in an urban school district, especially for students at higher risk for dropout. This study supports the theory that benefits of SBHCs extend beyond managing physical and mental health needs to include academic outcomes.
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Detecting Postpartum Depression in Referents to Medical and Health Centers in Hamadan City
Directory of Open Access Journals (Sweden)
F. Shobeiri
2007-10-01
Full Text Available Introduction & Objective: Pregnancy and childbirth are significant developmental excitable for most women. Physical, intrapersonal and relational adaptations are needed to adjust successfully to pregnancy and delivery. Postpartum depression is a serious psychiatric disorder and the adverse impact on infants has been noted. The purpose of this study was to detect postpartum depression in referents to medical and health centers in Hamadan city.Materials & Methods: A descriptive and cross-sectional study involving 400 women completed the Beck Depression Inventory (BDI within 2-8 weeks of delivery was conducted in urban health centers in Hamadan city, Iran. Data were collected through interviews with women in the clinics in the health centers. Data processing and statistical analysis were performed using SPSS 10.0.Results: The results revealed that majority of women (68.0% were considered normal. Depression was detected in 32.0% of women. Out of these 19.0, 4.0 and 9.0% were mild, moderate and severe depression, respectively. There were statistically significant differences between postpartum depression and age, number of delivery, education, job and husband's job (P=0.000.Conclusion: Nearly 32.0% of selected women had depression. Therefore, it is important for medical personnel to be well versed in the course and treatment of postpartum depression. Post partum depression should be screened and treated as early as possible for several reasons. It can cause significant suffering for the woman who experiences it, and it can have deleterious consequences for the newborn.
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Wang, Zhaoxin; Shi, Jianwei; Wu, Zhigui; Xie, Huiling; Yu, Yifan; Li, Ping; Liu, Rui; Jing, Limei
2017-07-01
Since the 1980s, China has been criticized for its mode of chronic disease management (CDM) that passively provides treatment in secondary and tertiary hospitals but lacks active prevention in community health centers (CHCs). Since there are few systematic evaluations of the CHCs' methods for CDM, this study aimed to analyze their abilities. On the macroperspective, we searched the literature in China's largest and most authoritative databases and the official websites of health departments. Literature was used to analyze the government's efforts in improving CHCs' abilities to perform CDM. At the microlevel, we examined the CHCs' longitudinal data after the New Health Reform in 2009, including financial investment, facilities, professional capacities, and the conducted CDM activities. A policy analysis showed that there was an increasing tendency towards government efforts in developing CDM, and the peak appeared in 2009. By evaluating the reform at CHCs, we found that there was an obvious increase in fiscal and public health subsidies, large-scale equipment, general practitioners, and public health physicians. The benefited vulnerable population in this area also rose significantly. However, rural centers were inferior in their CDM abilities compared with urban ones, and the referral system is still not effective in China. This study showed that CHCs are increasingly valued in managing chronic diseases, especially after the New Health Reform in 2009. However, we still need to improve collaborative management for chronic diseases in the community and strengthen the abilities of CHCs, especially in rural areas. Copyright © 2017 John Wiley & Sons, Ltd.
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Urban poverty and utilization of maternal and child health care services in India.
Prakash, Ravi; Kumar, Abhishek
2013-07-01
Drawing upon data from the third round of the National Family Health Survey (NFHS-3) conducted in India during 2005-06, this study compares the utilization of selected maternal and child health care services between the urban poor and non-poor in India and across selected Indian states. A wealth index was created, separately for urban areas, using Principal Component Analysis to identify the urban poor. The findings suggest that the indicators of maternal and child health care are worse among the urban poor than in their non-poor counterparts. For instance, the levels of antenatal care, safe delivery and childhood vaccinations are much lower among the urban poor than non-poor, especially in socioeconomically disadvantageous states. Among all the maternal and child health care indicators, the non-poor/poor difference is most pronounced for delivery care in the country and across the states. Other than poverty status, utilization of antenatal services by mothers increases the chances of safe delivery and child immunization at both national and sub-national levels. The poverty status of the household emerged as a significant barrier to utilization of health care services in urban India.
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Sociostructural factors influencing health behaviors of urban African-American men.
Plowden, Keith O; Young, Anthony E
2003-06-01
African-American men are suffering disproportionately from most illnesses. Seemingly, action is needed if health disparities that disproportionately affect African-American men as compared to their White and female counterparts are to be reduced or eliminated. An important step in decreasing common health disparities evidenced among African-American men is to understand social factors that act as motivators and barriers to seeking care for most of this vulnerable population. Following a constructionist epistemology, this study used ethnography to explore social structure factors that motivate urban African-American men to seek care. Leininger's Culture Care Diversity and Universality Theory guided this study. Qualitative interviews were conducted with urban African-American men and other individuals in the community to explore understanding, attitudes, and beliefs about health. Critical issues examined included social factors associated with health seeking behaviors. Themes that emerged from these data indicated that critical social factors include: 1) Kinship/significant others; 2) accessibility of resources; 3) ethnohealth belief; and 4) accepting caring environment. The data also indicated a relationship between these social factors and health seeking behaviors of urban African-American men.
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75 FR 2549 - Health Center Program
2010-01-15
... Program AGENCY: Health Resources and Services Administration, HHS ACTION: Notice of Noncompetitive Replacement Award to Regional Health Care Affiliates. SUMMARY: The Health Resources and Services Administration (HRSA) will be transferring Health Center Program (section 330 of the Public Health Service Act...
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Neighborhood-health links: Differences between rural-to-urban migrants and natives in Shanghai
Directory of Open Access Journals (Sweden)
Danan Gu
2015-09-01
Full Text Available Background: It is well known that migrant workers tend to have different perceptions of neighborhood environments than urban natives. However, less is known about how these differences in perception may be linked to the health of members of these two groups. Objective: We investigated differences in links between perceived neighborhood social and physical environments and three health outcomes, self-rated health, social stress, and chronic conditions, between rural-to-urban migrants (migrant workers and Shanghai-born native urban residents in China. Methods: Data used in this study were based on a survey of 477 rural-to-urban migrants and 546 native urban residents aged 18-64, conducted in Shanghai in 2008. Logistic regression analyses were performed to model relationships for migrant workers and native residents. Results: We found that among migrant workers, more positive perceptions of neighborhood social environments (social cohesion and safety were linked to better self-rated health and lower levels of perceived stress but were not linked to chronic disease conditions; there were also no links between perceptions of physical environments and any of the three health outcomes of this study among migrant workers. By contrast, among urban natives, more positive perceptions of neighborhood social environments were linked to lower odds of chronic disease conditions but were not linked to self-rated health and perceived stress; more positive perceptions of physical environments (amenities and air quality were linked with lower odds of social stress and of chronic disease conditions. Conclusions: Neighborhood social and physical environments affected the health of migrant workers and urban natives differently.
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Johnson, Christopher; Saba, George; Wolf, Jessica; Gardner, Heather; Thom, David H
2018-05-01
To examine activities of health coaches during patient medical visits and when meeting one-on-one with patients at 3 urban federally qualified health centers. Encounters were videotaped and transcribed. Data was analyzed using a matrix analysis approach that allowed a priori identification of expected categories of activity, based on the health coach training model and previously developed conceptual framework, which were modified based on activities observed. A total of 10 medical visits (patient, clinician and health coach), and 8 patient-coach visits were recorded. We identified 9 categories common to both medical and patient-coach visits and 2 categories unique to the medical visit. While observed activities were generally consistent with expected categories, some activities were observed infrequently or not at all. We also observed additional activity categories, including information gathering and personal conversation. The average amount of time spent on some categories of coaching activities differed substantially between medical visits and patient-coach visits. Health coaching activities observed differed in several respects to those expected, and differed between medical visits and coaching only visits. These results provide insights into health coaching behaviors that can be used to inform training and improve utilization of health coaches in practice. Copyright © 2017 Elsevier B.V. All rights reserved.
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78 FR 42788 - School-Based Health Center Program
2013-07-17
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration School-Based... Gadsden County. SUMMARY: HRSA will be transferring a School-Based Health Center Capital (SBHCC) Program... support the expansion of services at school-based health centers will continue. SUPPLEMENTARY INFORMATION...
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Accelerated Adoption of Advanced Health Information Technology in Beacon Community Health Centers.
Jones, Emily; Wittie, Michael
2015-01-01
To complement national and state-level HITECH Act programs, 17 Beacon communities were funded to fuel community-wide use of health information technology to improve quality. Health centers in Beacon communities received supplemental funding. This article explores the association between participation in the Beacon program and the adoption of electronic health records. Using the 2010-2012 Uniform Data System, trends in health information technology adoption among health centers located within and outside of Beacon communities were explored using differences in mean t tests and multivariate logistic regression. Electronic health record adoption was widespread and rapidly growing in all health centers, especially quality improvement functionalities: structured data capture, order and results management, and clinical decision support. Adoption lagged for functionalities supporting patient engagement, performance measurement, care coordination, and public health. The use of advanced functionalities such as care coordination grew faster in Beacon health centers, and Beacon health centers had 1.7 times higher odds of adopting health records with basic safety and quality functionalities in 2010-2012. Three factors likely underlie these findings: technical assistance, community-wide activation supporting health information exchange, and the layering of financial incentives. Additional technical assistance and community-wide activation is needed to support the use of functionalities that are currently lagging. © Copyright 2015 by the American Board of Family Medicine.
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(Un)Healthy in the City : Respiratory, Cardiometabolic and Mental Health Associated with Urbanity
Zijlema, Wilma L.; Klijs, Bart; Stolk, Ronald P.; Rosmalen, Judith G. M.
2015-01-01
Background Research has shown that health differences exist between urban and rural areas. Most studies conducted, however, have focused on single health outcomes and have not assessed to what extent the association of urbanity with health is explained by population composition or socioeconomic
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(Un)Healthy in the City : Respiratory, Cardiometabolic and Mental Health Associated with Urbanity
Zijlema, Wilma L.; Klijs, Bart; Stolk, Ronald P.; Rosmalen, Judith G. M.
2015-01-01
BACKGROUND: Research has shown that health differences exist between urban and rural areas. Most studies conducted, however, have focused on single health outcomes and have not assessed to what extent the association of urbanity with health is explained by population composition or socioeconomic
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Green Spaces as an Indicator of Urban Health: Evaluating Its Changes in 28 Mega-Cities
Directory of Open Access Journals (Sweden)
Conghong Huang
2017-12-01
Full Text Available Urban green spaces can yield considerable health benefits to urban residents. Assessing these health benefits is a key step for managing urban green spaces for human health and wellbeing in cities. In this study, we assessed the change of health benefits generated by urban green spaces in 28 megacities worldwide between 2005 and 2015 by using availability and accessibility as proxy indicators. We first mapped land covers of 28 megacities using 10,823 scenes of Landsat images and a random forest classifier running on Google Earth Engine. We then calculated the availability and accessibility of urban green spaces using the land cover maps and gridded population data. The results showed that the mean availability of urban green spaces in these megacities increased from 27.63% in 2005 to 31.74% in 2015. The mean accessibility of urban green spaces increased from 65.76% in 2005 to 72.86% in 2015. The increased availability and accessibility of urban green spaces in megacities have brought more health benefits to their residents.
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Including public-health benefits of trees in urban-forestry decision making
Geoffrey H. Donovan
2017-01-01
Research demonstrating the biophysical benefits of urban trees are often used to justify investments in urban forestry. Far less emphasis, however, is placed on the non-bio-physical benefits such as improvements in public health. Indeed, the public-health benefits of trees may be significantly larger than the biophysical benefits, and, therefore, failure to account for...
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Health Screening Behaviour among Female Urban Dwellers
Directory of Open Access Journals (Sweden)
Nik Nairan Abdullah
2016-01-01
Full Text Available An ageing population is a public health challenge, affects most countries. Health screenings are able to detect diseases at the earliest stage. A cross-sectional study in December 2014 conducted among 643 older women who randomly interviewed using structured questionnaire from two urban governmental health centres in Malaysia. Aims of the study were to describe health screening services behaviour and health care accessibility among women aged 50 and above. Factors such as living arrangement and age played important roles in health screening execution among older female community dwellers. Advocacy on health screening is vital as to reduce the morbidity and mortality among them.
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Urban Green Space and Its Impact on Human Health
Michelle Kondo; Jaime Fluehr; Thomas McKeon; Charles. Branas
2018-01-01
Background: Over half of the world's population now lives in urban areas, and this proportion is expected to increase. While there have been numerous reviews of empirical studies on the link between nature and human health, very few have focused on the urban context, and most have examined almost exclusively cross-sectional research. This...
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76 FR 1441 - Health Center Program
2011-01-10
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Health Center Program AGENCY: Health Resources and Services Administration, HHS. ACTION: Notice of Noncompetitive... for Services (IDS) and a portion of the Capital Improvement Project (CIP) from Saint Vincent's...
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Electricity and risk of public health center had measles vaccine damage in Indonesia
Directory of Open Access Journals (Sweden)
Anggita Bunga Anggraini
2016-03-01
related to PHC hadmeasles damage vaccines.Methods: The analysis used a part of the data of Research Health Facilities (Rifaskes in 2011. The Rifaskeswas conducted in all health centers in all (33 provinces in Indonesia. Furthermore, this analysis uses dataonly health center in the province who have measles immunization coverage the national prevalence rate(81.6% or more, and health centers that have measles prevalence rate above the national prevalence rate(1.18% or more. Statistical data analysis performed using logistic regression analysis to determine someof the risk factors related to the health center had has measles vaccine damaged.Results: A number of 7 provinces (Riau, Jakarta, West Nusa Tenggara, East Nusa Tenggara, CentralSulawesi, South Sulawesi, Gorontalo with 1259 PHC met the inclusion criteria. Health centers locatedin rural areas compared with urban areas had 3.4-fold risk of a PHC that had measles damage vaccines[adjusted odds ratio (ORa = 3.37; 95% confidence interval (CI = 1.34 - 8.26]. Furthermore, the healthcenter with the availability of the electricity for less than 24 hours compared with available 24 hours had2.1-fold risk of PHC that had measles damage vaccines (ORa = 2.10; 95% CI = 1.02 - 4.33.Conclusion: Public health center in rural areas, or did not have not have commercial electric power, ordid not have the availability of day-to-day electricity less than 24 hours had more risk of a PHC that hadmeasles damage vaccines. (Health Science Journal of Indonesia 2015;6:116-20Keywords: measles, public health center, vaccine
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Gender and rural-urban differences in reported health status by older people in Bangladesh.
Kabir, Zarina Nahar; Tishelman, Carol; Agüero-Torres, Hedda; Chowdhury, A M R; Winblad, Bengt; Höjer, Bengt
2003-01-01
The study aims to (i) describe regional variation and gender differences in health status of older people (60 years and older) in Bangladesh, indicated by self-reported health problems and functional ability; (ii) explore influence of socio-economic factors on health status of older people. In a cross-sectional study in rural and urban Bangladesh, 696 older persons were asked about their health problems and ability to manage activities of daily living (ADL). More than 95% of older people reported health problems. Approximately 80% of elderly women in both the regions reported having four or more health problems compared with 42% and 63% elderly men in the urban and rural regions, respectively. More women (urban: 55%; rural: 36%) than men (urban: 32%; rural: 22%) also reported difficulties with ADL. Irrespective of age, sex and area of residence, those reporting greater number of health problems were more likely to report difficulty with at least one ADL task. Reporting pattern of specific health problems varied between urban and rural regions. Socio-economic indicators were found to have little influence on reporting of health problems, particularly in the rural region. Observed regional difference may be related to the influence of social and environmental factors, and level of awareness concerning certain health conditions.
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Chen, Walter; Shiao, Wen-Been; Lin, Blossom Yen-Ju; Lin, Cheng-Chieh
2013-12-01
Different geographical areas with unique social cultures or societies might influence immigrant health. This study examines whether health inequities and different social factors exist regarding the health of rural and urban married Asian immigrants. A survey was conducted on 419 rural and 582 urban married Asian immigrants in Taiwan in 2009. Whereas the descriptive results indicate a worse mental health status between rural and urban married Asian immigrants, rural married immigrants were as mentally healthy as urban ones when considering different social variables. An analysis of regional stratification found different social-determinant patterns on rural and urban married immigrants. Whereas social support is key for rural immigrant physical and mental health, acculturation (i.e., language proficiency), socioeconomics (i.e., working status), and family structure (the number of family members and children living in the family) are key to the mental health of urban married immigrants in addition to social support. This study verifies the key roles of social determinants on the subjective health of married Asian immigrants. Area-differential patterns on immigrant health might act as a reference for national authorities to (re)focus their attention toward more area-specific approaches for married Asian immigrants.
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Neighborhood Environment and Self-Rated Health Among Urban Older Adults
Directory of Open Access Journals (Sweden)
Arlesia Mathis PhD
2015-09-01
Full Text Available Objective: This study examines associations between neighborhood environment and self-rated health (SRH among urban older adults. Method: We selected 217 individuals aged 65+ living in a de-industrialized Midwestern city who answered questions on the 2009 Speak to Your Health survey. The relationship between neighborhood environment and SRH was analyzed using regression models. Neighborhood variables included social support and participation, perceived racism, and crime. Additional models included actual crime indices to compare differences between perceived and actual crime. Results: Seniors who have poor SRH are 21% more likely to report fear of crime than seniors with excellent SRH ( p = .01. Additional analyses revealed Black seniors are 7% less likely to participate in social activities ( p = .005 and 4% more likely to report experiencing racism ( p < .001. Discussion: More than 80% of older adults live in urban areas. By 2030, older adults will account for 20% of the U.S. population. Given the increasing numbers of older adults living in urban neighborhoods, studies such as this one are important. Mitigating environmental influences in the neighborhood that are associated with poor SRH may allow urban older adults to maintain health and reduce disability.
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Science–policy challenges for biodiversity, public health and urbanization: examples from Belgium
International Nuclear Information System (INIS)
Keune, H; De Blust, G; Van den Berge, K; Brosens, D; Van Herzele, A; Simoens, I; Kretsch, C; Gilbert, M; Linard, C; Flandroy, L; Versteirt, V; Hartig, T; De Keersmaecker, L; Eggermont, H; Dessein, J; Vanwambeke, S; Prieur-Richard, A H; Wittmer, H; Martens, P; Mathijs, E
2013-01-01
Internationally, the importance of a coordinated effort to protect both biodiversity and public health is more and more recognized. These issues are often concentrated or particularly challenging in urban areas, and therefore on-going urbanization worldwide raises particular issues both for the conservation of living natural resources and for population health strategies. These challenges include significant difficulties associated with sustainable management of urban ecosystems, urban development planning, social cohesion and public health. An important element of the challenge is the need to interface between different forms of knowledge and different actors from science and policy. We illustrate this with examples from Belgium, showcasing concrete cases of human–nature interaction. To better tackle these challenges, since 2011, actors in science, policy and the broader Belgian society have launched a number of initiatives to deal in a more integrated manner with combined biodiversity and public health challenges in the face of ongoing urbanization. This emerging community of practice in Belgium exemplifies the importance of interfacing at different levels. (1) Bridges must be built between science and the complex biodiversity/ecosystem–human/public health–urbanization phenomena. (2) Bridges between different professional communities and disciplines are urgently needed. (3) Closer collaboration between science and policy, and between science and societal practice is needed. Moreover, within each of these communities closer collaboration between specialized sections is needed. (letter)
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Fowkes, Virginia; Blossom, H John; Mitchell, Brenda; Herrera-Mata, Lydia
2014-01-01
Increased access to insurance under the Affordable Care Act will increase demands for clinical services in community health centers (CHCs). CHCs also have an increasingly important educational role to train clinicians who will remain to practice in community clinics. CHCs and Area Health Education Centers (AHECs) are logical partners to prepare the health workforce for the future. Both are sponsored by the Health Resources and Services Administration, and they share a mission to improve quality of care in medically underserved communities. AHECs emphasize the educational side of the mission, and CHCs the service side. Building stronger partnerships between them can facilitate a balance between education and service needs.From 2004 to 2011, the California Statewide AHEC program and its 12 community AHECs (centers) reorganized to align training with CHC workforce priorities. Eight centers merged into CHC consortia; others established close partnerships with CHCs in their respective regions. The authors discuss issues considered and approaches taken to make these changes. Collaborative innovative processes with program leadership, staff, and center directors revised the program mission, developed common training objectives with an evaluation plan, and defined organizational, functional, and impact characteristics for successful AHECs in California. During this planning, centers gained confidence as educational arms for the safety net and began collaborations with statewide programs as well as among themselves. The AHEC reorganization and the processes used to develop, strengthen, and identify standards for centers forged the development of new partnerships and established academic-community trust in planning and implementing programs with CHCs.
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A new methodology for modelling of health risk from urban flooding exemplified by cholera
DEFF Research Database (Denmark)
Mark, Ole; Jørgensen, Claus; Hammond, Michael
2016-01-01
outlines a novel methodology for linking dynamic urban flood modelling with quantitative microbial risk assessment (QMRA). This provides a unique possibility for understanding the interaction between urban flooding and health risk caused by direct human contact with the flood water and hence gives...... and mortality, especially during floods. At present, there are no software tools capable of combining hydrodynamic modelling and health risk analyses, and the links between urban flooding and the health risk for the population due to direct contact with the flood water are poorly understood. The present paper...... an option for reducing the burden of disease in the population by use of intelligent urban flood risk management. The model linking urban flooding and health risk is applied to Dhaka City in Bangladesh, where waterborne diseases including cholera are endemic. The application to Dhaka City is supported...
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Zhuang, Xiao Yu; Wong, Daniel Fu Keung
2017-02-01
The number of internal migrant children in China has reached 35.8 million by the end of 2010. Previous studies revealed inconsistent findings regarding the mental health status of rural-to-urban migrant adolescents, as well as the impact of peer, teacher and parental support on the mental health of Chinese adolescent migrants. Using a comparative approach, this study attempted to compare the mental health status between migrant and urban-born adolescents and to clarify the specific roles of different sources of social support in the mental health of migrant and urban adolescents. A cross-sectional survey using a cluster convenience sampling strategy was performed in Beijing, China. A structured questionnaire was filled out by 368 rural-to-urban migrant adolescents and 325 urban-born adolescents. A significant difference was found only for positive affect (PA) but not for negative affect (NA) between the two groups, favouring the urban-born adolescents. Social support from all the three sources were all predictive of PA among rural-to-urban migrant adolescents, while only peer support contributed to PA among urban-born adolescents. Unexpectedly, teachers' support contributed to an increase in NA among urban-born adolescents. The findings contribute to understanding of the mental health status of migrant adolescents in China and the differential impact of the various sources of social support on migrant and urban-born adolescents. Also the findings may inform the development of mental health services and programmes that can potentially benefit a large number of internal migrant adolescents in China.
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Xie, Xuefeng; Pu, Lijie
2017-08-21
Urban public health is an important global issue and receives public concern. The urban ecosystem health (UEH) indicator system was constructed with 27 assessment indicators selected from vigor, organization, resilience, service function, and population health, then the matter element analysis (MEA) and analytic hierarchy process (AHP) weighting method were used to assess the UEH of each city in Jiangsu Province during the period of 2000-2014. The results show that the overall ecosystem health status of each city shows continuous improvement. The UEH status of each city gradually transferred from poor, general, and medium condition to good and excellent condition. From the perspective of spatial distribution, the city's UEH showing a steady status after increasing for 10 years, and their spatial variations have gradually reduced. The UEH status in Southern Jiangsu and Central Jiangsu was better than that of Northern Jiangsu Province. From each component point of view, the vigor, resilience, and population health of each city in Jiangsu Province showed a trend of continuous improvement, while the organization and service function first increased and then decreased. The common limiting factors of UEH in Jiangsu Province were Engel's coefficient of urban households, number of beds of hospitals, health centers per 10,000 people, and total investment in the treatment of environmental pollution as percent GDP. These results help decision makers to make suitable decisions to maintain the UEH of each city in Jiangsu Province.
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The Relationship between Community Violence Exposure and Mental Health Symptoms in Urban Adolescents
McDonald, Catherine C.; Richmond, Therese R.
2008-01-01
Urban adolescents are exposed to a substantial amount of community violence which has the potential to influence psychological functioning. To examine the relationship between community violence exposure and mental health symptoms in urban adolescents, a literature review using MEDLINE, CINAHL, PubMed, PsycINFO, CSA Social Services, and CSA Sociological Abstracts was conducted. Search terms included adolescent/adolescence, violence, urban, mental health, well-being, emotional distress, depres...
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Maternal health service utilization in urban slums of selected towns ...
African Journals Online (AJOL)
EPHA USER33
Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia; ... still women in urban settings do not use available maternal health services. Especially ... health services, safe water supplies, poor sanitation and .... selected cities are confined to crowded places, lack of.
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Brook, Jeffrey R; Setton, Eleanor M; Seed, Evan; Shooshtari, Mahdi; Doiron, Dany
2018-01-08
Multiple external environmental exposures related to residential location and urban form including, air pollutants, noise, greenness, and walkability have been linked to health impacts or benefits. The Canadian Urban Environmental Health Research Consortium (CANUE) was established to facilitate the linkage of extensive geospatial exposure data to existing Canadian cohorts and administrative health data holdings. We hypothesize that this linkage will enable investigators to test a variety of their own hypotheses related to the interdependent associations of built environment features with diverse health outcomes encompassed by the cohorts and administrative data. We developed a protocol for compiling measures of built environment features that quantify exposure; vary spatially on the urban and suburban scale; and can be modified through changes in policy or individual behaviour to benefit health. These measures fall into six domains: air quality, noise, greenness, weather/climate, and transportation and neighbourhood factors; and will be indexed to six-digit postal codes to facilitate merging with health databases. Initial efforts focus on existing data and include estimates of air pollutants, greenness, temperature extremes, and neighbourhood walkability and socioeconomic characteristics. Key gaps will be addressed for noise exposure, with a new national model being developed, and for transportation-related exposures, with detailed estimates of truck volumes and diesel emissions now underway in selected cities. Improvements to existing exposure estimates are planned, primarily by increasing temporal and/or spatial resolution given new satellite-based sensors and more detailed national air quality modelling. Novel metrics are also planned for walkability and food environments, green space access and function and life-long climate-related exposures based on local climate zones. Critical challenges exist, for example, the quantity and quality of input data to many of
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Urban political ecologies of informal recyclers׳ health in Buenos Aires, Argentina.
Parizeau, Kate
2015-05-01
Buenos Aires׳ informal recyclers (cartoneros) confront multiple health hazards in their work. Based in a survey with (n=397) informal recyclers, this study establishes that these workers experience uneven health landscapes as evidenced through their health outcomes, the social determinants of their health, and their living and working environments. I argue that the analytical framework of urban political ecology can provide insights to the ways that the urban environments where cartoneros live and work are socially-constructed phenomena, drawing on concepts of crisis, metabolism, and multi-scalar analyses. Copyright © 2015 Elsevier Ltd. All rights reserved.
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[Effects of urban noise on mental health].
Belojević, G; Jakovljević, B; Kocijancić, R; Pjerotić, L; Dimitrijević, J
1995-01-01
The results of the latest studies on the effects of urban noise on mental health are presented in this paper. Numerous psychiatric symptoms have been frequently noticed in the population of the settlements with a high level of urban noise: fatigue, headaches, tension, anxiety, irritability, bad concentration, insomnia, whith a consequently high consumption of psychotropic medicines. Higher admission rates in psychiatric hospitals have been noticed from noisy areas in comparison with low noise regions. By use of diagnostic psychiatric interviews it has been shown as well, that in sensitive categories of population positive correlation can be expected between the number of persons with mental disorder and the level of environmental noise. Noise annoyance and sleep disturbance, namely shortening or absence of the sleep phase 4 and REM, are the basic negative psychological effects of noise, with an adverse effect on mental health in general.
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Discrimination, perceived social inequity, and mental health among rural-to-urban migrants in China.
Lin, Danhua; Li, Xiaoming; Wang, Bo; Hong, Yan; Fang, Xiaoyi; Qin, Xiong; Stanton, Bonita
2011-04-01
Status-based discrimination and inequity have been associated with the process of migration, especially with economics-driven internal migration. However, their association with mental health among economy-driven internal migrants in developing countries is rarely assessed. This study examines discriminatory experiences and perceived social inequity in relation to mental health status among rural-to-urban migrants in China. Cross-sectional data were collected from 1,006 rural-to-urban migrants in 2004-2005 in Beijing, China. Participants reported their perceptions and experiences of being discriminated in daily life in urban destination and perceived social inequity. Mental health was measured using the symptom checklist-90 (SCL-90). Multivariate analyses using general linear model were performed to test the effect of discriminatory experience and perceived social inequity on mental health. Experience of discrimination was positively associated with male gender, being married at least once, poorer health status, shorter duration of migration, and middle range of personal income. Likewise, perceived social inequity was associated with poorer health status, higher education attainment, and lower personal income. Multivariate analyses indicate that both experience of discrimination and perceived social inequity were strongly associated with mental health problems of rural-to-urban migrants. Experience of discrimination in daily life and perceived social inequity have a significant influence on mental health among rural-to-urban migrants. The findings underscore the needs to reduce public or societal discrimination against rural-to-urban migrants, to eliminate structural barriers (i.e., dual household registrations) for migrants to fully benefit from the urban economic development, and to create a positive atmosphere to improve migrant's psychological well-being.
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International Nuclear Information System (INIS)
Su, Meirong; Fath, Brian D.; Yang, Zhifeng; Chen, Bin; Liu, Gengyuan
2013-01-01
The evaluation of ecosystem health in urban clusters will help establish effective management that promotes sustainable regional development. To standardize the application of emergy synthesis and set pair analysis (EM–SPA) in ecosystem health assessment, a procedure for using EM–SPA models was established in this paper by combining the ability of emergy synthesis to reflect health status from a biophysical perspective with the ability of set pair analysis to describe extensive relationships among different variables. Based on the EM–SPA model, the relative health levels of selected urban clusters and their related ecosystem health patterns were characterized. The health states of three typical Chinese urban clusters – Jing-Jin-Tang, Yangtze River Delta, and Pearl River Delta – were investigated using the model. The results showed that the health status of the Pearl River Delta was relatively good; the health for the Yangtze River Delta was poor. As for the specific health characteristics, the Pearl River Delta and Yangtze River Delta urban clusters were relatively strong in Vigor, Resilience, and Urban ecosystem service function maintenance, while the Jing-Jin-Tang was relatively strong in organizational structure and environmental impact. Guidelines for managing these different urban clusters were put forward based on the analysis of the results of this study. - Highlights: • The use of integrated emergy synthesis and set pair analysis model was standardized. • The integrated model was applied on the scale of an urban cluster. • Health patterns of different urban clusters were compared. • Policy suggestions were provided based on the health pattern analysis
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Academic health centers and society: an ethical reflection.
Pellegrino, E D
1999-08-01
Academic health centers--which combine university, medical school, and hospital--exist to satisfy universal human needs and thus are by definition instruments of social purpose. Their core mission is threefold: to provide medical knowledge that can help relieve and prevent illness and suffering, to supply practitioners able to apply that knowledge wisely, and to serve as sites where optimal use of medical knowledge can be demonstrated and investigated. Maintaining a balance between core mission and responsiveness to social trends is a delicate exercise. Overly close accommodation to such trends can endanger the core mission, as has occurred in the United States with regard to managed care. Society and academic health centers have mutual obligations. Obligations of society include giving academic health centers financial and other support and allowing them sufficient freedom to pursue their mission; obligations of academic medical centers include accepting greater scrutiny by society and providing social criticism on matters relating to health. A task for the future is to discern how academic health centers can be responsive to social needs without being totally subservient to societal desires.
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The Variables Associated With Health Promotion Behaviors Among Urban Black Women.
Hepburn, Millie
2018-04-24
To improve understanding of variables impacting health promotion behaviors among urban Black women. A cross-sectional survey was used. Urban Black women (N = 132) between the ages of 30 to 64 years participated. The study was conducted in a U.S. metropolitan region in 2015. Health literacy (Newest Vital Sign [NVS]), self-efficacy (New General Self-Efficacy Scale [NGSE]), and readiness for change (Health Risk Instrument [HRI]) were correlated with health promotion behaviors (Health Promotion Lifestyle Profile II [HPLPII]). Univariate statistics addressed demographic characteristics; bivariate/simultaneous linear regression determined the relationships between the NVS, NGSE, and HRI to health promotion behaviors (HPLPII). Demographics: 72.6% completed high school and 25% completed college, and the mean body mass index (BMI) was >32. Positive correlations existed between each variable to health promotion behaviors: NVS (r = .244, p promotion behaviors. Education and health literacy were also correlated (r s = .414, p = .001). Although health literacy, self-efficacy, and readiness for change are associated with health promotion behaviors, readiness for change was the most highly correlated. The development and incorporation of interventions to promote health promotion behaviors should include readiness for change, health literacy, BMI, and education, especially among urban Black women in order to reduce critical health disparities. Community-based and culturally relevant strategies in promoting health that are integrated into existing lifestyles and designed to impact readiness for change will have the greatest impact on reducing health disparities both in the United States and in countries experiencing rapid urbanization. For example, healthy eating behaviors or increased physical activity may be best adopted when integrated into existing community-based spiritual or cultural events via trusted community leaders. Replication of this study in other populations of Black
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Pearson, Hattie; Fleming, Tyler; Chhoun, Pheak; Tuot, Sovannary; Brody, Carinne; Yi, Siyan
2018-04-02
Traditional, complementary and alternative medicine (TCAM) is seen as a way to provide healthcare in both developed and developing countries across the world. In Cambodia, there is a long tradition of using TCAM. However, scant studies have been conducted on the extent of Cambodian TCAM use and how it interacts with allopathic health care to date. In this study, we examined the prevalence of and factors associated with utilization of herbal medicines among patients with chronic diseases in primary health care settings in Cambodia. A cross-sectional survey was conducted in 2015 with outpatients receiving treatment and care for chronic diseases in two urban and two rural primary health centers purposively selected from Phnom Penh, Kampong Cham and Siem Reap. Every eligible patient was randomly selected at the health centers using a systematic sampling procedure. I-CAM-Q was used to measure TCAM use. A multivariate logistic regression model was constructed to identify factors associated with herbal medicine use. In total, 1602 patients were included in this study, of whom 77.7% were female, and 51.2% were recruited from urban primary health centers with a mean age of 46.5 years (SD = 15.2). Of total, 27.0% reported at least one consultation with a TCAM provider in the past 12 months. The most common modality of TCAM used was herbal medicine (89%). Herbs were obtained at drug or folk stores (36.9%), from herbalists directly (28.5%) or from their own gardens (18.6%). Of herb users, 55.2% reported that herbs were somewhat helpful. After adjustment, herb users were significantly more likely to be female (AOR = 1.42, 95% CI = 1.12-2.67), have completed less schooling (AOR = 0.66, 95% CI = 0.45-0.96), were unemployed or homemakers (AOR = 0.23, 95% CI = 0.13-0.52) and have a gastrointestinal illness (AOR = 0.49, 95% CI = 0.39-0.62). Herbal medicines are broadly used among chronic disease patients in Cambodia. Understanding TCAM use in
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Oral health knowledge of health care workers in special?children?s center
Wyne, Amjad; Hammad, Nouf; Splieth, Christian
2015-01-01
Objective: To determine the oral health knowledge of health care workers in special children?s center. Methods: A self-administered questionnaire was used to collect following information: demographics, oral hygiene practices, importance of fluoride, dental visits, cause of tooth decay, gingival health, and sources of oral health information. The study was conducted at Riyadh Center for Special Children in Riyadh City from December 2013 to May 2014. Results: All 60 health care workers in the ...
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Jennings, Viniece; Larson, Lincoln; Yun, Jessica
2016-01-01
Urban green spaces provide an array of benefits, or ecosystem services, that support our physical, psychological, and social health. In many cases, however, these benefits are not equitably distributed across diverse urban populations. In this paper, we explore relationships between cultural ecosystem services provided by urban green space and the social determinants of health outlined in the United States Healthy People 2020 initiative. Specifically, we: (1) explore connections between cultural ecosystem services and social determinants of health; (2) examine cultural ecosystem services as nature-based health amenities to promote social equity; and (3) recommend areas for future research examining links between urban green space and public health within the context of environmental justice. PMID:26861365
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Rural-Urban Disparities in Health and Health Care in Africa: Cultural ...
African Journals Online (AJOL)
medical health care system, rural-urban disparities would seem obvious. .... have led to the development and onset of the illness and cure/controllability, what the ..... and then went back for the result but the nurse that I saw said that I should ...
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Cheng, Jingru; Wang, Tian; Li, Fei; Xiao, Ya; Bi, Jianlu; Chen, Jieyu; Sun, Xiaomin; Wu, Liuguo; Wu, Shengwei; Liu, Yanyan; Luo, Ren; Zhao, Xiaoshan
2015-01-01
This study aimed to investigate whether self-rated health status (SRH) and subjective health complaints (SHC) of urban Chinese women are associated with their health-promoting lifestyles (HPL). We conducted a cross-sectional study on 8142 eligible Chinese participants between 2012 and 2013. Demographic and SHC data were collected. Each subject completed the SRH questionnaire and the Chinese version of the Health-Promoting Lifestyle Profile-II (HPLP-II). Correlation and binary regression analyses were performed to examine the associations of SRH and SHC with HPL. Both SRH and HPL of urban Chinese women were moderate. The most common complaints were fatigue (1972, 24.2%), eye discomfort (1571, 19.3%), and insomnia (1542, 18.9%). Teachers, highly educated subjects and elderly women had lower SRH scores, while college students and married women had better HPL. All items of HPLP-II were positively correlated with SRH (r = 0.127-0.533, P = 0.000) and negatively correlated with SHC to a significant extent (odds ratio [OR] = 1.40-11.37). Aspects of HPL, particularly stress management and spiritual growth, are associated with higher SRH and lower SHC ratings among urban Chinese women. Physical activity and health responsibility are additionally related to reduced fatigue and nervousness. We believe that these findings will be instrumental in encouraging researchers and urban women to adopt better health-promoting lifestyles with different priorities in their daily lives.
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Implementation of Urban Health Equity Assessment and Response Tool: a Case of Matsapha, Swaziland.
Makadzange, Kevin; Radebe, Zamahlubi; Maseko, Nokuthula; Lukhele, Voyivoyi; Masuku, Sabelo; Fakudze, Gciniwe; Mengestu, Tigest Ketsela; Prasad, Amit
2018-04-03
Equity in health implies that ideally everyone could attain their full health potential and that no one should be disadvantaged from achieving this potential because of their social position or other socially determined circumstances. Making cities and human settlements inclusive, safe, resilient and sustainable contributes towards ensuring healthy lives and promoting well-being for all at all ages in dignity, equality and in a healthy environment. This paper illustrates a case of applying the Urban Health Equity Assessment and Response Tool (Urban HEART) in a small town in Africa. It describes the process followed, facilitating factors and challenges faced. A descriptive single-case study design using qualitative research methods was adopted to collect data from purposively selected respondents. The study revealed that residents of the Matsapha peri-urban informal settlements faced challenges with conditions of daily living which impacted negatively on their health. There were health equity gaps. The application of the tools was facilitated by the formation of an all-inclusive team, intersectoral collaboration and incorporating strategies for improving urban health equity into existing programmes and projects. Urban HEART is a simple and easy to use valuable tool for pursuing the goal of health equity towards attaining sustainable development through evidence-based approaches for intersectoral action and community involvement.
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Challenges in managing and sustaining urban slum health ...
African Journals Online (AJOL)
Challenges in managing and sustaining urban slum health programmes in Kenya. ... These were hardly implemented in the projects, according to the data gathered. ... Conclusion: Land and income were big issues according to the responses.
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Branchet, Perrine; Cadot, Emmanuelle; Fenet, Hélène; Sebag, David; Ngatcha, Benjamin Ngounou; Borrell-Estupina, Valérie; Ngoupayou, Jules Remy Ndam; Kengne, Ives; Braun, Jean-Jacques; Gonzalez, Catherine
2018-04-18
Urban agriculture is crucial to local populations, but the risk of it contaminating water has rarely been documented. The aim of this study was to assess pesticide contamination of surface waters from the Méfou watershed (Yaoundé, Cameroon) by 32 selected herbicides, fungicides, and insecticides (mainly polar) according to their local application, using both grab sampling and polar organic compounds integrative samplers (POCIS). Three sampling campaigns were conducted in the March/April and October/November 2015 and June/July 2016 rainy seasons in urban and peri-urban areas. The majority of the targeted compounds were detected. The quantification frequencies of eight pesticides were more than 20% with both POCIS and grab sampling, and that of diuron and atrazine reached 100%. Spatial differences in contamination were evidenced with higher contamination in urban than peri-urban rivers. In particular, diuron was identified as an urban contaminant of concern because its concentrations frequently exceeded the European water quality guideline of 0.200 μg/L in freshwater and may thus represent an ecological risk due to a risk quotient > 1 for algae observed in 94% of grab samples. This study raises concerns about the impacts of urban agriculture on the quality of water resources and to a larger extent on the health of the inhabitants of cities in developing countries. Graphical abstract ᅟ.
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2014-06-01
behaviors were solely enacted within the physical bounds of an urban center- mall , outdoor shopping plaza, or downtown, to name a few. The Internet has...Homans, G. 1974. Social Behavior , revised ed. New York: Harcourt-Brace. Langford, Gary O. 2012. Engineering Systems Integration: Theory , Metrics, and...merging of city theory ( plans , goals, aggregate functions) with physical design (Levy 2013). City planning takes into consideration the needs, benefits
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Krupinski, J
1979-06-01
Australia is one of the most urbanized countries in the world with over 85% of the population living in metropolitan and other urban areas. More important, the change from a predominantly rural society to an urbanized society has occurred within the last 100 years. To assess the effects of urbanization on mental health, rates of admissions to psychiatric institutions, suicides and violent crime in Victoria have been analysed for the last hundred years. Data on admissions to psychiatric facilities in Victoria from metropolitan, other urban and rural areas, as well as results of community health surveys carried out in metropolitan and rural areas were compared to examine for evidence of urban-rural differences in psychiatric morbidity. The findings do not support the notion that the level of psychiatric and psychosocial disorders in Victoria are related to urbanization or to urban living.
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Linking evidence to action on social determinants of health using Urban HEART in the Americas.
Prasad, Amit; Groot, Ana Maria Mahecha; Monteiro, Teofilo; Murphy, Kelly; O'Campo, Patricia; Broide, Emilia Estivalet; Kano, Megumi
2013-12-01
To evaluate the experience of select cities in the Americas using the Urban Health Equity Assessment and Response Tool (Urban HEART) launched by the World Health Organization in 2010 and to determine its utility in supporting government efforts to improve health equity using the social determinants of health (SDH) approach. The Urban HEART experience was evaluated in four cities from 2010-2013: Guarulhos (Brazil), Toronto (Canada), and Bogotá and Medellín (Colombia). Reports were submitted by Urban HEART teams in each city and supplemented by first-hand accounts of key informants. The analysis considered each city's networks and the resources it used to implement Urban HEART; the process by which each city identified equity gaps and prioritized interventions; and finally, the facilitators and barriers encountered, along with next steps. In three cities, local governments spearheaded the process, while in the fourth (Toronto), academia initiated and led the process. All cities used Urban HEART as a platform to engage multiple stakeholders. Urban HEART's Matrix and Monitor were used to identify equity gaps within cities. While Bogotá and Medellín prioritized among existing interventions, Guarulhos adopted new interventions focused on deprived districts. Actions were taken on intermediate determinants, e.g., health systems access, and structural SDH, e.g., unemployment and human rights. Urban HEART provides local governments with a simple and systematic method for assessing and responding to health inequity. Through the SDH approach, the tool has provided a platform for intersectoral action and community involvement. While some areas of guidance could be strengthened, Urban HEART is a useful tool for directing local action on health inequities, and should be scaled up within the Region of the Americas, building upon current experience.
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Linking evidence to action on social determinants of health using Urban HEART in the Americas
Directory of Open Access Journals (Sweden)
Amit Prasad
2013-12-01
Full Text Available OBJECTIVE: To evaluate the experience of select cities in the Americas using the Urban Health Equity Assessment and Response Tool (Urban HEART launched by the World Health Organization in 2010 and to determine its utility in supporting government efforts to improve health equity using the social determinants of health (SDH approach METHODS: The Urban HEART experience was evaluated in four cities from 2010-2013: Guarulhos (Brazil, Toronto (Canada, and Bogotá and Medellín (Colombia. Reports were submitted by Urban HEART teams in each city and supplemented by first-hand accounts of key informants. The analysis considered each city's networks and the resources it used to implement Urban HEART; the process by which each city identified equity gaps and prioritized interventions; and finally, the facilitators and barriers encountered, along with next steps RESULTS: In three cities, local governments spearheaded the process, while in the fourth (Toronto, academia initiated and led the process. All cities used Urban HEART as a platform to engage multiple stakeholders. Urban HEART's Matrix and Monitor were used to identify equity gaps within cities. While Bogotá and Medellín prioritized among existing interventions, Guarulhos adopted new interventions focused on deprived districts. Actions were taken on intermediate determinants, e.g., health systems access, and structural SDH, e.g., unemployment and human rights CONCLUSIONS: Urban HEART provides local governments with a simple and systematic method for assessing and responding to health inequity. Through the SDH approach, the tool has provided a platform for intersectoral action and community involvement. While some areas of guidance could be strengthened, Urban HEART is a useful tool for directing local action on health inequities, and should be scaled up within the Region of the Americas, building upon current experience.
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Rural vs urban hospital performance in a 'competitive' public health service.
Garcia-Lacalle, Javier; Martin, Emilio
2010-09-01
In some western countries, market-driven reforms to improve efficiency and quality have harmed the performance of some hospitals, occasionally leading to their closure, mostly in rural areas. This paper seeks to explore whether these reforms affect urban and rural hospitals differently in a European health service. Rural and urban hospital performance is compared taking into account their efficiency and perceived quality. The study is focused on the Andalusian Health Service (SAS) in Spain, which has implemented a freedom of hospital choice policy and a reimbursement system based on hospital performance. Data Envelopment Analysis, the Mann-Whitney U test and Multidimensional Scaling techniques are conducted for two years, 2003 and 2006. The results show that rural and urban hospitals perform similarly in the efficiency dimension, whereas rural hospitals perform significantly better than urban hospitals in the patient satisfaction dimension. When the two dimensions are considered jointly, some rural hospitals are found to be the best performers. As such, market-driven reforms do not necessary result in a difference in the performance of rural and urban hospitals. Copyright 2010 Elsevier Ltd. All rights reserved.
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Role of the health center in health crisis management, especially in a radiation disaster
International Nuclear Information System (INIS)
Kurahashi, Toshiyuki
2013-01-01
In a disaster, in particular a radiation disaster, health centers should play an active role in taking advantage of its own expertise. There are various causes of a health crisis; the response to a health crisis is defined according to each cause. However, it should be adequately addressed by assuming the worst case for a health crisis of unknown cause. The role of health centers, in addition to the implementation of appropriate and timely treatment of any health crisis, is prevention of a future health crisis, advanced preparation, and damage recovery; activities during normal times are also important to maintain. Regarding the specific activities of the health center, judgment in the preference of measures to be performed is important. That the information is collected properly based on the idea of risk communication, coordination, and public relations transmission is required also for health centers. (author)
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1992-05-01
Urban centers are growing due to natural increase and the movement of people from rural areas. Urban areas are the traditional centers of trade, science, and culture, but growth over a threshold results in crime, congestion, and pollution. Sustainability is threatened in modern towns that are dependent on other sources for food, fuel, or water. Housing, water, food supplies, and sanitation, communication, and transportation services are threatened in rapidly growing cities. In 1990 45/100 people lived in towns or cities. Hyper-cities have grown in number to 20, of which 14 are in developing countries. 83% of world population increase is expected to occur in cities. In 48 countries with faster population growth cities had growth rates averaging about 6.1% per year, and the urban share of total population averaged 2.8%. In 49 countries with slower population growth, urban growth rates averaged only 3.6% per year, and the urban share of total population averaged about 1.8%. Squatter settlements are endemic to urban areas that are congested and without basic services, limited housing particularly for the poor, and few job opportunities. The number of street children in urban areas has risen. This child population is subjected to low wages, overwork, auto accidents, poor health, and lack of social services. Malnutrition is a more serious issue in urban areas. In the Philippines malnutrition is 3% nationally and 9% in Metro Manila. Rural land reform in the Philippines is no longer a viable solution. In Metro Manila squatters are expected to increase in number to 4 million people by the year 2000, which would be almost 50% of total population. The squatter areas are areas of neglect, decay, and poverty. Cities are viewed as development's "blind alleys."
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Work motivation and job satisfaction of health workers in urban and rural areas.
Grujičić, Maja; Jovičić-Bata, Jelena; Rađen, Slavica; Novaković, Budimka; Šipetić-Grujičić, Sandra
2016-08-01
Motivated and job satisfied health professionals represent a basis of success of modern health institutions. The aim of this study was to investigate whether there was a difference in work motivation and job satisfaction between health workers in urban and rural areas in the region of Central Serbia. The study included 396 health professionals from urban setting, and 436 from a rural area, employed in four randomly selected health facilities. An anonymous questionnaire was used for data gathering. Statistical analysis was performed using χ2, Student t-test, Spearman's correlation coefficient, and logistic regression analysis. Urban health professionals were significantly more motivated and job satisfied than respondents from rural area. In relation to work motivation factors and job satisfaction of health professionals in urban and rural areas, there were no significant differences in working conditions and current equipment, and in terms of job satisfaction there were no significant differences in relation to income either. In order to increase the level of work motivation and job satisfaction of health workers in rural areas, apart from better income, they should get more assistance and support from their supervisors, and awards for good job performance; interpersonal relationships, promotion and advancement opportunities, managerial performance and cooperation at work should be improved; employment security should be provided, as well as more independence at work, with professional supervision of health workers.
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Recruiting community health centers into pragmatic research: Findings from STOP CRC.
Coronado, Gloria D; Retecki, Sally; Schneider, Jennifer; Taplin, Stephen H; Burdick, Tim; Green, Beverly B
2016-04-01
Challenges of recruiting participants into pragmatic trials, particularly at the level of the health system, remain largely unexplored. As part of Strategies and Opportunities to STOP Colon Cancer in Priority Populations (STOP CRC), we recruited eight separate community health centers (consisting of 26 individual safety net clinics) into a large comparative effectiveness pragmatic study to evaluate methods of raising the rates of colorectal cancer screening. In partnership with STOP CRC's advisory board, we defined criteria to identify eligible health centers and applied these criteria to a list of health centers in Washington, Oregon, and California affiliated with Oregon Community Health Information Network, a 16-state practice-based research network of federally sponsored health centers. Project staff contacted centers that met eligibility criteria and arranged in-person meetings of key study investigators with health center leadership teams. We used the Consolidated Framework for Implementation Research to thematically analyze the content of discussions during these meetings to identify major facilitators of and barriers to health center participation. From an initial list of 41 health centers, 11 met the initial inclusion criteria. Of these, leaders at three centers declined and at eight centers (26 clinic sites) agreed to participate (73%). Participating and nonparticipating health centers were similar with respect to clinic size, percent Hispanic patients, and percent uninsured patients. Participating health centers had higher proportions of Medicaid patients and higher baseline colorectal cancer screening rates. Common facilitators of participation were perception by center leadership that the project was an opportunity to increase colorectal cancer screening rates and to use electronic health record tools for population management. Barriers to participation were concerns of center leaders about ability to provide fecal testing to and assure follow-up of
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Urban health and ecology: the promise of an avian biomonitoring tool.
Pollack, Lea; Ondrasek, Naomi R; Calisi, Rebecca
2017-04-01
Urban-dwelling birds have the potential to serve as powerful biomonitors that reveal the impact of environmental change due to urbanization. Specifically, urban bird populations can be used to survey cities for factors that may pose both public and wildlife health concerns. Here, we review evidence supporting the use of avian biomonitors to identify threats associated with urbanization, including bioaccumulation of toxicants and the dysregulation of behavior and physiology by related stressors. In addition, we consider the use of birds to examine how factors in the urban environment can impact immunity against communicable pathogens. By studying the behavior, physiology, and ecology of urban bird populations, we can elucidate not only how avian populations are responding to environmental change, but also how unintended consequences of urbanization affect the well-being of human and non-human inhabitants.
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Directory of Open Access Journals (Sweden)
Ata Chokhachian
2017-12-01
Full Text Available The concept of resilience in urban design and decision-making is principally focused on change instead of resistance over an adaptive process. For cities, this concept in a broader scale means how to withstand unforeseen events that will fundamentally amend the city’s wellbeing, rather than being stabilized and protected. The same concept is applicable for outdoor comfort as an adaptive approach to compensate extreme heat waves and health risk conditions. This chapter presents methods, tools, and applications to enhance urban resilience at a micro scale looking for correlations between environmental factors and human behavior in terms of outdoor comfort.
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Position of Social Determinants of Health in Urban Man-Made Lakes
Shojaei, Parisa; Karimlou, Masoud; Mohammadi, Farahnaz; Afzali, Hosein Malek; Forouzan, Ameneh Setareh
2013-01-01
Background and Objective: A social determinants approach proposes that enhancing living conditions in areas such as income, housing, transportation, employment, education, social support, and health services is central to improving the health of urban populations. Urban development projects can be costly but have health impacts. The benefit derived from the creation of man-made lakes in developing countries is usually associated with great risks; however, the evidence for physical and non-physical health benefits of urban man-made lake is unclear. The aim of this paper is to formulate a conceptual framework of associations between urban man-made lakes and social determinants of health. Method: This study was a qualitative study carried out using one focus group discussion and 16 individual interviews. Data were analyzed based on deductive-inductive content analysis approach. Results: Participants’ points of view were analyzed within 261 codes. Data analysis matrix was the conceptual framework of social determinants of health commission and its sub-groups, thus, two structural and mediating determinants categories as well as their sub-sets were created accordingly. In addition, some extra sub-sets including environment, air quality, weather changes, noise pollution, pathogenesis, quality of life, shortage of available resources, region popularity, ethnicity, tourism, social and physical development of children, unintentional injuries, aesthetic, and spirituality were extracted beyond the matrix factors, which were placed in each of above categories based on their thematic content. Conclusion: This paper has illustrated that the quality and type of man-made lake provided within communities can have a significant and sustained impact on community’s health and wellbeing. Therefore, in order to strengthen positive effects and reduce negative effects of any developmental projects within community, their impacts on public health should be taken into consideration
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Directory of Open Access Journals (Sweden)
Jingru Cheng
Full Text Available This study aimed to investigate whether self-rated health status (SRH and subjective health complaints (SHC of urban Chinese women are associated with their health-promoting lifestyles (HPL.We conducted a cross-sectional study on 8142 eligible Chinese participants between 2012 and 2013. Demographic and SHC data were collected. Each subject completed the SRH questionnaire and the Chinese version of the Health-Promoting Lifestyle Profile-II (HPLP-II. Correlation and binary regression analyses were performed to examine the associations of SRH and SHC with HPL.Both SRH and HPL of urban Chinese women were moderate. The most common complaints were fatigue (1972, 24.2%, eye discomfort (1571, 19.3%, and insomnia (1542, 18.9%. Teachers, highly educated subjects and elderly women had lower SRH scores, while college students and married women had better HPL. All items of HPLP-II were positively correlated with SRH (r = 0.127-0.533, P = 0.000 and negatively correlated with SHC to a significant extent (odds ratio [OR] = 1.40-11.37.Aspects of HPL, particularly stress management and spiritual growth, are associated with higher SRH and lower SHC ratings among urban Chinese women. Physical activity and health responsibility are additionally related to reduced fatigue and nervousness. We believe that these findings will be instrumental in encouraging researchers and urban women to adopt better health-promoting lifestyles with different priorities in their daily lives.
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Center for Environmental Health Sciences
Federal Laboratory Consortium — The primary research objective of the Center for Environmental Health Sciences (CEHS) at the University of Montana is to advance knowledge of environmental impacts...
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Center for Devices and Radiological Health Publications Index, August 1988
International Nuclear Information System (INIS)
1988-08-01
This is the first Publications Index to be published by the Center for Devices and Radiological Health. Previous indexes, titled 'Bureau of Radiological Health Publications Index', were published before the Center was formed in 1982 through the merger of the Bureau of Radiological Health and the Bureau of Medical Devices; the last of these indexes was published in October 1980. The 1988 edition contains records of medical device and radiological health documents authored or published by the Center from 1978 through 1986. It should not be considered all-inclusive since those documents for which bibliographic information was not available have been excluded. The Publications Index is being distributed to Center staff, state radiological health programs, and libraries on the Center's publication mailing list. The Center plans to update and publish the Index every other year to provide a convenient record of published Center documents
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Variability in urban soils influences the health and growth of native tree seedlings
Clara C. Pregitzer; Nancy F. Sonti; Richard A. Hallett
2016-01-01
Reforesting degraded urban landscapes is important due to the many benefits urban forests provide. Urban soils are highly variable, yet little is known about how this variability in urban soils influences tree seedling performance and survival. We conducted a greenhouse study to assess health, growth, and survival of four native tree species growing in native glacial...
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Mental Health Services in School-Based Health Centers: Systematic Review
Bains, Ranbir Mangat; Diallo, Ana F.
2016-01-01
Mental health issues affect 20-25% of children and adolescents, of which few receive services. School-based health centers (SBHCs) provide access to mental health services to children and adolescents within their schools. A systematic review of literature was undertaken to review evidence on the effectiveness of delivery of mental health services…
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The Role of Urban Financial Centers within the Economy of Global Cities
Directory of Open Access Journals (Sweden)
Oana Mionel
2014-06-01
Full Text Available Nowadays, there is no doubt that state economy refers to city economy. In other words, the most part of a state‘s GDP is given by the urban environment, especially by capitals, which are often the economic engine of this environment. There are also cities having great economic importance abroad, beyond the state and even continental borders. These are the so-called global cities where the financial activities play an important role. There are a few cities (New York, London, Hong Kong etc. centering financial activities which are influential for large geographic areas. This research highlights the importance of the financial sector within urban economy and, subsequently, how it consolidates the status of global city. These cities are the engine of the international financial system as they host the headquarters of the most important and famous international stock exchange markets, financial supervision institutions, law firms and consulting companies.
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Are health centers in Thailand ready for health information technology? : a national survey.
Kijsanayotin, Boonchai; Speedie, Stuart
2006-01-01
The Thailand universal health care coverage scheme was instituted in 2001 and The Thailand Ministry of Public Health (MOPH) is restructuring its information systems to support this reform. The MOPH anticipates developing computerized health information systems which can provide information for administration tasks and can improve both healthcare delivery and public health services. To achieve these target goals, knowledge about users and organizations is vital. The knowledge of how health center workers currently use information technology (IT), their knowledge of IT, and acceptance of IT are not only beneficial to policy makers but also to system designers and implementers. The primary objective of this study is to learn how health centers in Thailand use IT, the level of basic IT knowledge among their workers, and their acceptance of health IT. We surveyed a random cross sectional sample of 1,607 health centers representing the total of 9,806 in Thailand in 2005. With an 82% response rate, the preliminary results indicate that information technology usage is pervasive in health centers. The respondents showed a moderately high degree of health information technology acceptance with a modest level of basic IT knowledge. There were no differences in degrees of acceptance among the four geographic regions. The mean score of "intention to use IT" was 5.6 on a scale of 7 and the average basic IT knowledge score was 13 out of 20. These results suggests the possibility of project success if the national health center information system projects are developed and implemented.
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Consequences of urban pollution on health; Consequences de la pollution urbaine sur la sante
Energy Technology Data Exchange (ETDEWEB)
Adedeji, A. [Agence pour la Protection de l' Environnement de l' Etat de Lagos, Lagos State Environmental Protection Agency - Lasepa (Nigeria)
2002-11-01
This article treats of the urbanization process in Africa and of the direct impact of urban pollution on people's health. After a description of the spectacular growth of urban populations in Africa since 1970, the author focusses on the experience of Nigeria and on the city of Lagos: urbanization causes, demographic growth, origins of urban pollution (road traffic, uncontrolled wastes tipping, sanitary conditions) and different types of pollution (atmospheric, hydric, domestic wastes, noise, heat..). The second part of the article deals with the impact of this urban pollution on the public health in conditions of overpopulation: domestic environment, diseases linked with water quality, diseases transmission, accidents, occupational diseases. This analysis stresses on the lack of urban management and development policies in Nigeria, and on the lack of a representative, liable and competent public authority. (J.S.)
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Rural-urban disparity in oral health-related quality of life.
Gaber, Amal; Galarneau, Chantal; Feine, Jocelyne S; Emami, Elham
2018-04-01
The objective of this population-based cross-sectional study was to estimate rural-urban disparity in the oral health-related quality of life (OHRQoL) of the Quebec adult population. A 2-stage sampling design was used to collect data from the 1788 parents/caregivers of schoolchildren living in the 8 regions of the province of Quebec in Canada. Andersen's behavioural model for health services utilization was used as a conceptual framework. Place of residency was defined according to the Statistics Canada Census Metropolitan Area and Census Agglomeration Influenced Zone classification. The outcome of interest was OHRQoL measured using the Oral Health Impact Profile (OHIP)-14 validated questionnaire. Data weighting was applied, and the prevalence, extent and severity of negative oral health impacts were calculated. Statistical analyses included descriptive statistics, bivariate analyses and binary logistic regression. The prevalence of poor oral health-related quality life (OHRQoL) was statistically higher in rural areas than in urban zones (P = .02). Rural residents reported a significantly higher prevalence of negative daily-life impacts in pain, psychological discomfort and social disability OHIP domains (P < .05). Additionally, the rural population showed a greater number of negative oral health impacts (P = .03). There was no significant rural-urban difference in the severity of poor oral health. Logistic regression indicated that the prevalence of poor OHRQoL was significantly related to place of residency (OR = 1.6; 95% CI = 1.1-2.5; P = .022), perceived oral health (OR = 9.4; 95% CI = 5.7-15.5; P < .001), dental treatment needs factors (perceived need for dental treatment, pain, dental care seeking) (OR = 8.7; 95% CI = 4.8-15.6; P < .001) and education (OR = 2.7; 95% CI = 1.8-3.9; P < .001). The results of this study suggest a potential difference in OHRQoL of Quebec rural and urban populations, and a need to develop strategies to promote oral health outcomes
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Oral health status of rural-urban migrant children in South China.
Gao, Xiao-Li; McGrath, Colman; Lin, Huan-Cai
2011-01-01
In China, there is a massive rural-urban migration and the children of migrants are often unregistered residents (a 'floating population'). This pilot study aimed to profile the oral health of migrant children in South China's principal city of migration and identify its socio-demographic/behavioural determinants. An epidemiological survey was conducted in an area of Guangzhou among 5-year-old migrant children (n = 138) who received oral examinations according to the World Health Organization criteria. Parents' oral health knowledge/attitude, child practices, and impact of children's oral health on their quality-of-life (QoL) were assessed. The caries rate and mean (SD) dmft were 86% and 5.17 (4.16), respectively, higher than those national statistics for both rural and urban areas (P Oral hygiene was satisfactory (DI-S Oral health impacts on QoL were considerable; 60% reported one or more impacts. 58% variance in 'dmft' was explained by 'non-local-born', 'low-educated parents', 'bedtime feeding', 'parental unawareness of fluoride's effect and importance of teeth', and 'poor oral hygiene' (all P oral health-related QoL (both P Oral health is poor among rural-urban migrant children and requires effective interventions in targeted sub-groups. © 2010 The Authors. International Journal of Paediatric Dentistry © 2010 BSPD, IAPD and Blackwell Publishing Ltd.
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Urban versus rural populations' views of health care in Scotland.
Farmer, Jane; Hinds, Kerstin; Richards, Helen; Godden, David
2005-10-01
To compare satisfaction with, and expectations of, health care of people in rural and urban areas of Scotland. Questions were included in the 2002 Scottish Social Attitudes Survey (SSAS). The Scottish House-hold Survey urban-rural classification was used to categorize locations. A random sample of 2707 people was contacted to participate in a face-to-face interview and a self-completion questionnaire survey. SPSS (v.10) was used to analyse the data. Relationships between location category and responses were explored using logistic regression analysis. In all, 1665 (61.5%) interviews were conducted and 1507 (56.0%) respondents returned self-completion questionnaires. Satisfaction with local doctors and hospital services was higher in rural locations. While around 40% of those living in remote areas thought A&E services too distant, this did not rank as a top priority for health service improvement. This could be due to expectations that general practitioners would assist in out-of-hours emergencies. Most Scots thought services should be good in rural areas even if this was costly, and that older people should not be discouraged from moving to rural areas because of their likely health care needs. In all, 79% of respondents thought that care should be as good in rural as urban areas. Responses to many questions were independently significantly affected by rural/urban location. Most Scots want rural health care to continue to be good, but the new UK National Health Service (NHS) general practitioner contract and service redesign will impact on provision. Current high satisfaction, likely to be due to access and expectations about local help, could be affected. This study provides baseline data on attitudes and expectations before potential service redesign, which should be monitored at intervals in future.
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Ge, Ying; Se, Jun; Zhang, Jingfu
2015-01-01
Aim: In this research, we attempted at exploring the relationships among urban left-behind children’s internet-addiction, personality traits and mental health. Methods: In the form of three relevant questionnaires (Adolescent Pathological Internet Use Scale, Eysenck Personality Questionnaire, Children’s Edition in Chinese and Mental Health Test), 796 urban left-behind children in China were investigated, concerning internet-addiction, personality traits and mental health. Results: (1) The internet-addiction rate of urban left-behind children in China reached10.8%—a relatively high figure, with the rate among males higher than that among females. In terms of internet-addition salience, the figure of urban left-behind children was obviously higher than that of non-left-behind children. (2) In China, the personality deviation rate of the overall left-behind children was 15.36%; while the personality deviation rate of the internet-addicted urban left-behind children was 38.88%, a figure prominently higher than that of the non-addicted urban left-behind children group, with the rate among females higher than that among males. (3) The mental health problem rate of the overall urban left-behind children in China was 8.43%; while the rate of the internet-addicted urban left-behind children was 27.77%, a figure significantly higher than that of the non-addicted urban left-behind children. (4) There were significant relationships among internet-addiction, personality traits and mental health. The total score of internet-addiction and its related dimensions can serve as indicators of personality neuroticism, psychoticism and the total scores of mental health. PMID:25946911
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Adolescent Health Care in School-Based Health Centers. Position Statement
National Assembly on School-Based Health Care, 2008
2008-01-01
School-based health centers (SBHCs) are considered one of the most effective strategies for delivering preventive care, including reproductive and mental health care services, to adolescents--a population long considered difficult to reach. National Assembly on School-Based Health Care (NASBHC) recommends practices and policies to assure…
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Urban Health Indicator Tools of the Physical Environment: a Systematic Review.
Pineo, Helen; Glonti, Ketevan; Rutter, Harry; Zimmermann, Nici; Wilkinson, Paul; Davies, Michael
2018-04-16
Urban health indicator (UHI) tools provide evidence about the health impacts of the physical urban environment which can be used in built environment policy and decision-making. Where UHI tools provide data at the neighborhood (and lower) scale they can provide valuable information about health inequalities and environmental deprivation. This review performs a census of UHI tools and explores their nature and characteristics (including how they represent, simplify or address complex systems) to increase understanding of their potential use by municipal built environment policy and decision-makers. We searched seven bibliographic databases, four key journals and six practitioner websites and conducted Google searches between January 27, 2016 and February 24, 2016 for UHI tools. We extracted data from primary studies and online indicator systems. We included 198 documents which identified 145 UHI tools comprising 8006 indicators, from which we developed a taxonomy. Our taxonomy classifies the significant diversity of UHI tools with respect to topic, spatial scale, format, scope and purpose. The proportions of UHI tools which measure data at the neighborhood and lower scale, and present data via interactive maps, have both increased over time. This is particularly relevant to built environment policy and decision-makers, reflects growing analytical capability and offers the potential for improved understanding of the complexity of influences on urban health (an aspect noted as a particular challenge by some indicator producers). The relation between urban health indicators and health impacts attributable to modifiable environmental characteristics is often indirect. Furthermore, the use of UHI tools in policy and decision-making appears to be limited, thus raising questions about the continued development of such tools by multiple organisations duplicating scarce resources. Further research is needed to understand the requirements of built environment policy and
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Health care employee perceptions of patient-centered care.
Balbale, Salva Najib; Turcios, Stephanie; LaVela, Sherri L
2015-03-01
Given the importance of health care employees in the delivery of patient-centered care, understanding their unique perspectives is essential for quality improvement. The purpose of this study was to use photovoice to evaluate perceptions and experiences around patient-centered care among U.S. Veterans Affairs (VA) health care employees. We asked participants to take photographs of salient features in their environment related to patient-centered care. We used the photographs to facilitate dialogue during follow-up interviews. Twelve VA health care employees across two VA sites participated in the project. Although most participants felt satisfied with their work environment and experiences at the VA, they identified several areas for improvement. These included a need for more employee health and wellness initiatives and a need for enhanced opportunities for training and professional growth. Application of photovoice enabled us to learn about employees' unique perspectives around patient-centered care while engaging them in an evaluation of care delivery. © The Author(s) 2014.
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DEFF Research Database (Denmark)
Okkels, Niels; Kristiansen, Christina Blanner; Munk-Jørgensen, Povl
2018-01-01
. Fast and unstructured urbanization, such as that seen in many developing countries, further exacerbates these challenges. There are promising initiatives emerging including initiatives to end homelessness, to improve access to green areas in urban environments, to provide emergency psychiatric services...
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Work motivation and job satisfaction of health workers in urban and rural areas
Directory of Open Access Journals (Sweden)
Grujičić Maja
2016-01-01
Full Text Available Background/Aim. Motivated and job satisfied health professionals represent a basis of success of modern health institutions. The aim of this study was to investigate whether there was a difference in work motivation and job satisfaction between health workers in urban and rural areas in the region of Central Serbia. Methods. The study included 396 health professionals from urban setting, and 436 from a rural area, employed in four randomly selected health facilities. An anonymous questionnaire was used for data gathering. Statistical analysis was performed using χ2, Student t-test, Spearman's correlation coefficient, and logistic regression analysis. Results. Urban health professionals were significantly more motivated and job satisfied than respondents from rural area. In relation to work motivation factors and job satisfaction of health professionals in urban and rural areas, there were no significant differences in working conditions and current equipment, and in terms of job satisfaction there were no significant differences in relation to income either. Conclusion. In order to increase the level of work motivation and job satisfaction of health workers in rural areas, apart from better income, they should get more assistance and support from their supervisors, and awards for good job performance; interpersonal relationships, promotion and advancement opportunities, managerial performance and cooperation at work should be improved; employment security should be provided, as well as more independence at work, with professional supervision of health workers.
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Urban Sustainability and Public Health: Throwing the Bath Water Out and Not the Baby
Quattrochi, Dale A.
2009-01-01
This slide presentation reviews the affect of urbanization on community health. It exams urbanization trends in the Atlanta metro area and includes information on impervious surfaces, air quality, mitigation strategies, spatial growth modeling, land use, public health surveillance and different data collection methods.
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Predictors of senior center use among older adults in New York City public housing.
Schneider, Amanda E; Ralph, Nancy; Olson, Carolyn; Flatley, Anne-Marie; Thorpe, Lorna
2014-12-01
Despite agreement among stakeholders that senior centers can promote physical and mental health, research on senior center use in urban populations is limited. Our objective was to describe demographic and health factors associated with senior center use among urban, low-income older adults in order to inform programming and outreach efforts. We used data from a 2009 telephone survey of 1036 adults randomly selected from rosters of New York City public housing residents aged 65 and older. We analyzed senior center use by race/ethnicity, age, gender, health, housing type, and income, and used a forward selection approach to build best-fit models predicting senior center use. Older adults of all ages and of both genders reported substantial use of senior centers, with nearly one third (31.3%) reporting use. Older adults living alone, at risk of depression, or living in specialized senior housing had the greatest use of centers. Senior center use varied by race/ethnicity, and English-speaking Hispanics had a higher prevalence of use than Spanish-speaking Hispanics (adjusted prevalence ratio [PR]=1.69, 95% CI: 1.11-2.59). Spanish-speaking communities and older adults living in non-senior congregate housing are appropriate targets for increased senior center outreach efforts.
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Liu, Hong; Rizzo, John A; Fang, Hai
2015-11-23
Hukou is the household registration system in China that determines eligibility for various welfare benefits, such as health care, education, housing, and employment. The hukou system may lead to nutritional and health disparities in China. We aim at examining the role of the hukou system in affecting urban-rural disparities in child nutrition, and disentangling the institutional effect of hukou from the effect of urban/rural residence on child nutrition-related health outcomes. This study uses data from the China Health and Nutrition Survey 1993-2009 with a sample of 9616 children under the age of 18. We compute height-for-age z-score and weight-for-age z-score for children. We use both descriptive statistics and multiple regression techniques to study the levels and significance of the association between child nutrition-related health outcomes and hukou type. Children with urban hukou have 0.25 (P system exacerbates urban-rural disparities in child nutrition-related health outcomes independent of the well-known disparity stemming from urban-rural residence. Fortunately, however, child health disparities due to hukou have been declining since 2000.
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Health Extension in New Mexico: An Academic Health Center and the Social Determinants of Disease
Kaufman, Arthur; Powell, Wayne; Alfero, Charles; Pacheco, Mario; Silverblatt, Helene; Anastasoff, Juliana; Ronquillo, Francisco; Lucero, Ken; Corriveau, Erin; Vanleit, Betsy; Alverson, Dale; Scott, Amy
2010-01-01
The Agricultural Cooperative Extension Service model offers academic health centers methodologies for community engagement that can address the social determinants of disease. The University of New Mexico Health Sciences Center developed Health Extension Rural Offices (HEROs) as a vehicle for its model of health extension. Health extension agents are located in rural communities across the state and are supported by regional coordinators and the Office of the Vice President for Community Health at the Health Sciences Center. The role of agents is to work with different sectors of the community in identifying high-priority health needs and linking those needs with university resources in education, clinical service and research. Community needs, interventions, and outcomes are monitored by county health report cards. The Health Sciences Center is a large and varied resource, the breadth and accessibility of which are mostly unknown to communities. Community health needs vary, and agents are able to tap into an array of existing health center resources to address those needs. Agents serve a broader purpose beyond immediate, strictly medical needs by addressing underlying social determinants of disease, such as school retention, food insecurity, and local economic development. Developing local capacity to address local needs has become an overriding concern. Community-based health extension agents can effectively bridge those needs with academic health center resources and extend those resources to address the underlying social determinants of disease. PMID:20065282
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Jitlada, C.; Pentamwa, P.
2018-03-01
This study aims to characterize airborne polycyclic aromatic hydrocarbons (PAHs) as of particulate and vapor phases variation. The samples were collected from the childcare centers where divided into urban and rural areas in Nakhon Ratchasima Province of Thailand. The airborne samples were collected from five childcare centers during the dry season in the year 2017. The PAHs species were determined by the gas chromatography and mass spectroscopy (GS/MS) method. Results show that the total concentrations of PAHs were higher than vapor phase that both similar in urban area and rural area. The dominant PAHs compounds of both urban and rural areas were benzo(a)pyrene, benzo(a,h)anthracene and indeno(1,2,3-cd)pyrene, respectively. Furthermore, the concentrations of PAHs in municipality (urban) childcare centers were higher than rural childcare centers area of Nakhon Ratchasima province. The risks associated with exposure to PAHs were evaluated using the TEF approach. The estimated value of lifetime lung cancer risks children in urban were significantly (p < 0.05) 2 times of children in rural, thus demonstrating that exposure to PAHs at levels found at urban site may be cause potential health risks.
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Urban physics : effect of the micro-climate on comfort, health and energy demand
Moonen, P.; Defraeye, T.W.J.; Dorer, V.; Blocken, B.J.E.; Carmeliet, J.E.
2012-01-01
The global trend towards urbanization explains the growing interest in the study of the modification of the urban climate due to the heat island effect and global warming, and its impact on energy use of buildings. Also urban comfort, health and durability, referring respectively to pedestrian
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Perrault, Evan K
2018-07-01
Campus health centers are a convenient, and usually affordable, location for college students to obtain health care. Staffed by licensed and trained professionals, these providers can generally offer similar levels of care that providers at off-campus clinics can deliver. Yet, previous research finds students may forgo this convenient, on-campus option partially because of a lack of knowledge regarding the quality of providers at these campus clinics. This study sought to examine where this information deficit may come from by analyzing campus health centers' online provider information. All Division-I colleges or universities with an on-campus health center, which had information on their websites about their providers (n = 294), had their providers' online information analyzed (n = 2,127 providers). Results revealed that schools commonly offer professional information (e.g., provider specialties, education), but very little about their providers outside of the medical context (e.g., hobbies) that would allow a prospective student patient to more easily relate. While 181 different kinds of credentials were provided next to providers' names (e.g., MD, PA-C, FNP-BC), only nine schools offered information to help students understand what these different credentials meant. Most schools had information about their providers within one-click of the homepage. Recommendations for improving online information about campus health center providers are offered.
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Utilization of maternal health services in rural primary health centers ...
African Journals Online (AJOL)
Utilization of maternal health services in rural primary health centers in Sub- Saharan Africa. ... their pregnancies were normal during antenatal care visits, hostile attitude of health workers, poverty and mode of payment. Majority of the PHCs provided antenatal, normal delivery, and post natal services. Rural mothers lacked ...
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Urban public health: is there a pyramid?
Su, Meirong; Chen, Bin; Yang, Zhifeng; Cai, Yanpeng; Wang, Jiao
2013-01-28
Early ecologists identified a pyramidal trophic structure in terms of number, biomass and energy transfer. In 1943, the psychologist Maslow put forward a pyramid model to describe layers of human needs. It is indicated that the pyramid principle is universally applicable in natural, humanistic and social disciplines. Here, we report that a pyramid structure also exists in urban public health (UPH). Based on 18 indicators, the UPH states of four cities (Beijing, Tokyo, New York, and London) are compared from the point of view of five aspects, namely physical health, living conditions, social security, environmental quality, and education and culture. A pyramid structure was found in each city when focusing on 2000-2009 data. The pyramid of Beijing is relatively similar to that of Tokyo, and the pyramids of New York and London are similar to each other. A general development trend in UPH is proposed and represented by different pyramid modes. As a basic conjecture, the UPH pyramid model can be verified and developed with data of more cities over a longer period, and be used to promote healthy urban development.
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Urban health. A challenge for the third millennium
International Nuclear Information System (INIS)
Caroli, S.; Menditto, A.
1999-01-01
In the frame of the bilateral governmental programme for scientific and technical cooperation existing between Italy and Hungary a successful series of biennial Symposia were undertaken since the early 1980s. These were designed to provide scientists of both countries with a permanent forum for the evaluation of ongoing joint projects, the exchange of views on future priorities dealt with by these Symposia always made the participation of prominent scientists from other countries a necessary complement substantially enhancing the international characteristics of such events. Each Symposium features a specific theme of primary importance within the general context of human health and environmental protection. In this respect, the ninth edition of this series of Symposia focuses on the major concerns raised by chemical pollution on all aspects of urban life. More than one half of the world population lives today in big cities, with all the attendant problems as regards air, water and soil quality, safe disposal of urban waste, occupational exposure, in one word, the physical, mental and cultural welfare of citizens at large. All facets concurring to protect and maintain urban health will be thus taken into consideration and highlighted in about forty invited lectures, while posters will be displayed in a permanent session throughout the conference duration [it
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Vogt, Florian; Kalenga, Lucien; Lukela, Jean; Salumu, Freddy; Diallo, Ibrahim; Nico, Elena; Lampart, Emmanuel; Van den Bergh, Rafael; Shah, Safieh; Ogundahunsi, Olumide; Zachariah, Rony; Van Griensven, Johan
2017-03-01
Facility-based antiretroviral therapy (ART) provision for stable patients with HIV congests health services in resource-limited countries. We assessed outcomes and risk factors for attrition after decentralization to community-based ART refill centers among 2603 patients with HIV in Kinshasa, Democratic Republic of Congo, using a multilevel Poisson regression model. Death, loss to follow-up, and transfer out were 0.3%, 9.0%, and 0.7%, respectively, at 24 months. Overall attrition was 5.66/100 person-years. Patients with >3 years on ART, >500 cluster of differentiation type-4 count, body mass index >18.5, and receiving nevirapine but not stavudine showed reduced attrition. ART refill centers are a promising task-shifting model in low-prevalence urban settings with high levels of stigma and poor ART coverage.
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Directory of Open Access Journals (Sweden)
Collins Charles D
2007-03-01
Full Text Available Abstract Background In 1997 there was a major reform of the government run urban health insurance system in China. The principal aims of the reform were to widen coverage of health insurance for the urban employed and contain medical costs. Following this reform there has been a transition from the dual system of the Government Insurance Scheme (GIS and Labour Insurance Scheme (LIS to the new Urban Employee Basic Health Insurance Scheme (BHIS. Methods This paper uses data from the National Health Services Surveys of 1998 and 2003 to examine the impact of the reform on population coverage. Particular attention is paid to coverage in terms of gender, age, employment status, and income levels. Following a description of the data between the two years, the paper will discuss the relationship between the insurance reform and the growing inequities in population coverage. Results An examination of the data reveals a number of key points: a The overall coverage of the newly established scheme has decreased from 1998 to 2003. b The proportion of the urban population without any type of health insurance arrangement remained almost the same between 1998 and 2003 in spite of the aim of the 1997 reform to increase the population coverage. c Higher levels of participation in mainstream insurance schemes (i.e. GIS-LIS and BHIS were identified among older age groups, males and high income groups. In some cases, the inequities in the system are increasing. d There has been an increase in coverage of the urban population by non-mainstream health insurance schemes, including non-commercial and commercial ones. The paper discusses three important issues in relation to urban insurance coverage: institutional diversity in the forms of insurance, labour force policy and the non-mainstream forms of commercial and non-commercial forms of insurance. Conclusion The paper concludes that the huge economic development and expansion has not resulted in a reduced disparity in
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Oral health knowledge of health care workers in special children's center.
Wyne, Amjad; Hammad, Nouf; Splieth, Christian
2015-01-01
To determine the oral health knowledge of health care workers in special children's center. A self-administered questionnaire was used to collect following information: demographics, oral hygiene practices, importance of fluoride, dental visits, cause of tooth decay, gingival health, and sources of oral health information. The study was conducted at Riyadh Center for Special Children in Riyadh City from December 2013 to May 2014. All 60 health care workers in the center completed the questionnaire. A great majority (95%) of the workers brushed their teeth twice or more daily. More than two-third (71.7%) of the workers knew that fluoride helps in caries prevention. One in five (21.7%) workers thought that a dental visit only becomes necessary in case of a dental problem. Similarly, 13.3% of the workers thought to "wait till there is some pain in case of a dental cavity" before seeking dental treatment. The workers ranked soft drinks/soda (98.3%), flavored fizzy drinks (60%) and sweetened/flavored milks (43.3%) as top three cariogenic drinks. A great majority (95%) of the workers correctly responded that blood on toothbrush most probably is a sign of "gum disease". Dentists (50%) and media (45%) were the main source of their oral health information. There was no significant difference (p > 0.05) in workers' response in relation to their specific job. The special health care workers in the disabled children's center generally had satisfactory oral health knowledge and practices.
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Health Impact Assessment of New Urban Water Concepts
Sales Ortells, H.
2015-01-01
Water features in urban areas are increasingly perceived by citizens as a positive element because they provide aesthetic quality to the neighbourhood and offer recreation opportunities. They may also lead, however, to increased health risks due to the potential presence of waterborne pathogens.
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78 FR 49357 - National Health Center Week, 2013
2013-08-14
... America A Proclamation Community health centers play a critical role in providing affordable, high-quality... people living in the United States depends on their services. They are an important source of jobs in... extend our thanks to the women and men who operate America's health centers. NOW, THEREFORE, I, BARACK...
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Development of an urban green space indicator and the public health rationale.
Annerstedt van den Bosch, Matilda; Mudu, Pierpaolo; Uscila, Valdas; Barrdahl, Maria; Kulinkina, Alexandra; Staatsen, Brigit; Swart, Wim; Kruize, Hanneke; Zurlyte, Ingrida; Egorov, Andrey I
2016-03-01
In this study, the aim was to develop and test an urban green space indicator for public health, as proposed by the World Health Organisation (WHO) Regional Office for Europe, in order to support health and environmental policies. We defined the indicator of green space accessibility as a proportion of an urban population living within a certain distance from a green space boundary. We developed a Geographic Information System (GIS)-based method and tested it in three case studies in Malmö, Sweden; Kaunas, Lithuania; and Utrecht, The Netherlands. Land use data in GIS from the Urban Atlas were combined with population data. Various population data formats, maximum distances to green spaces, minimum sizes of green spaces, and different definitions of green spaces were studied or discussed. Our results demonstrated that with increasing size of green space and decreased distance to green space, the indicator value decreased. As compared to Malmö and Utrecht, a relatively bigger proportion of the Kaunas population had access to large green spaces, at both shorter and longer distances. Our results also showed that applying the method of spatially aggregated population data was an acceptable alternative to using individual data. Based on reviewing the literature and the case studies, a 300 m maximum linear distance to the boundary of urban green spaces of a minimum size of 1 hectare are recommended as the default options for the indicator. The indicator can serve as a proxy measure for assessing public accessibility to urban green spaces, to provide comparable data across Europe and stimulate policy actions that recognise the importance of green spaces for sustainable public health. © 2015 the Nordic Societies of Public Health.
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Economic Segmentation and Health Inequalities in Urban Post-Reform China.
Kwon, Soyoung
2016-01-01
During economic reform, Chinese economic labor markets became segmented by state sector associated with a planned redistributive economy and private sector associated with the market economy. By considering an economic sector as a concrete institutional setting in post-reform China, this paper compares the extent to which socioeconomic status, measured by education and income, is associated with self-rated health between state sector and private sector. The sample is limited to urban Chinese employees between the ages of 18 and 55 who were active in the labor force. By analyzing pooled data from the 1991-2006 Chinese Health and Nutrition Survey , I find that there is a stronger association between income and self-rated health in the private sector than in the state sector. This study suggests that sectoral differences between market and redistributive economies are an important key to understanding health inequalities in post-reform urban China.
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Consequences of urban pollution on Health
Energy Technology Data Exchange (ETDEWEB)
Adedeji, A. [Lagos state Environmental Protection Agency (LASEPA), (Nigeria)
2000-07-01
In most urban areas, the major air pollutants as earlier highlighted are CO, PbO. SO{sub 2}. NO{sub x}. Hydrocarbons, particulate matters and even excess CO{sub 2}. Some of these have direct effects on health while some are of indirect effects. Other common gaseous emissions from industries are toxic waste fumes and dust/ fluff from spinning, weaving and other processes. In most cases when not properly taken care of may lead to human and plant lives being endangered. For instance it is an established fact that prolonged inhalation of fluff can also lead to Prysinosis with attendant symptoms of chest tightening and pain. In advanced stage, the situation could lead to tuberculosis. Similarly, heavy air pollution leads to acute and chronic harmful effects such as chronic bronchitis, asthma. dermatitis allergy and hypersensitivity. The processing houses produce substantial quantity of volatile chemicals. which pollute the air and could result in health impairment in human beings. It is sad to note that most African Countries including Nigeria still use leaded gasoline. The air quality degradation by these pollutants causes or aggravates most of the respiratory and air-borne diseases like asthma. tuberculosis etc which are rampant in a typical urban city like Lagos. The chart below buttresses this fact. (author)
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impact of waste disposal on health of a poor urban community
African Journals Online (AJOL)
2004-08-08
Aug 8, 2004 ... and local authorities' policies of hostilities and eviction of poor urban informal settlers(7). This study assessed the human excreta and waste disposal facilities and their health implications among residents of the poor urban settlement of Epworth a few kilometers south east of Harare, Zimbabwe's capital city.
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National Center for Health Statistics
... Submit Search the CDC National Center for Health Statistics Note: Javascript is disabled or is not supported ... Survey of Family Growth Vital Records National Vital Statistics System National Death Index Vital Statistics Rapid Release ...
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Abandonment, Ecological Assembly and Public Health Risks in Counter-Urbanizing Cities
Directory of Open Access Journals (Sweden)
Alexandra Gulachenski
2016-05-01
Full Text Available Urban landscapes can be transformed by widespread abandonment from population and economic decline. Ecological assembly, sometimes referred to as “greening”, following abandonment can yield valuable ecosystem services, but also can pose a risk to public health. Abandonment can elevate zoonotic vector-borne disease risk by favoring the hyperabundance of commensal pests and pathogen vectors. Though greater biodiversity in abandoned areas can potentially dilute vector-borne pathogen transmission, “greening” can elevate transmission risk by increasing movement of pathogen vectors between fragmented areas and by giving rise to novel human-wildlife interfaces. Idled and derelict infrastructure can further elevate disease risk from vector-borne and water-borne pathogens, which can build up in stagnant and unprotected water that maintenance and routine use of delivery or sanitation systems would otherwise eliminate. Thus, framing “greening” as inherently positive could result in policies and actions that unintentionally exacerbate inequalities by elevating risks rather than delivering benefits. As counter-urbanism is neither a minor pattern of urban development, nor a short-term departure from urban growth, homeowner and municipal management of abandoned areas should account for potential hazards to reduce health risks. Further socioecological assessments of public health risks following abandonment could better ensure the resilience and well-being of communities in shrinking cities.
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Cost-income analysis of oral health units of health care centers in Yazd city
Directory of Open Access Journals (Sweden)
Hosein Fallahzadeh
2012-01-01
Full Text Available Background and Aims: Increasing demands for health care's services on one hand and limited resources on the other hand brings about pressure over governments to find out a mechanism for fair and appropriate distribution of resources. Economic analysis is one of the appropriate tools for policy making on this priority. The aim of this study was to assess capital and consumption of oral health units of health care centers in Yazd city and comparing it with revenue of these centers and determining of cost effectiveness.Materials and Methods: In this descriptive cross sectional study, all health care centers of Yazd city with active dentistry department were evaluated. The data has been extracted from current documents in health care center of county based issued receipts and daily information registers.Results: Expended cost for providing of oral hygiene services in second half of 2008 in 13 medical health centers of Yazd included active dentistry section was 557.887.500 Rials and revenue to cost ratio was about 34%. The most provided service was related to tooth extraction and the average of tooth restoration in each working day was 0.48.Conclusion: With attention to low tariffs of dentistry services in medical health centers and paying subsidy to target groups, expenses of oral hygiene are always more than its revenue.
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75 FR 55587 - Family-to-Family Health Information Center Program
2010-09-13
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Family-to-Family Health Information Center Program AGENCY: Health Resources and Services Administration, HHS... Vermont Family-to-Family Health Information Center (F2F HIC) grant (H84MC00002) from the Parent to Parent...
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Zhu, Xiaolong; Cai, Qiong; Wang, Jin; Liu, Yun
2014-12-01
In recent years, medical and health care consumption has risen, making health risk an important determinant of household spending and welfare. We aimed to examine the determinants of medical and health care expenditure to help policy-makers in the improvement of China's health care system, benefiting the country, society and every household. This paper employs panel data from China's provinces from 2001 to 2011 with all possible economic variations and studies the determinants of medical and healthcare expenditure for urban residents. CPI (consumer price index) of medical services and the resident consumption level of urban residents have positive influence on medical and health care expenditures for urban residents, while the local medical budget, the number of health institutions, the incidence of infectious diseases, the year-end population and the savings of urban residents will not have effect on medical and health care expenditure for urban residents. This paper proposed three relevant policy suggestions for Chinese governments based on the findings of the research.
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Getrich, Christina; Heying, Shirley; Willging, Cathleen; Waitzkin, Howard
2007-07-01
Community-based health interventions have emerged as a growing focus for anthropological research. The application of ethnographic approaches in clinical practice settings reveals that community-based interventions must grapple with "noise," or unanticipated factors such as patients' own perceptions of illness and treatment, primary care providers' non-adherence to guidelines-based treatment, the social dynamics of the clinic site itself, and incomplete understanding and acceptance of an intervention by a clinic's staff members. Such noise can influence the implementation and quality of treatment. Thus, identifying clinic-based noise is critical in assessments of fidelity to intervention protocols as well as outcomes of community-based interventions. This paper highlights findings from an evaluation of a mental health intervention focusing on the role of promotoras (briefly trained, non-professional community health workers) as mental health practitioners in two urban New Mexico, USA, community health centers. Our research identified three areas of clinic-based noise: the clinics' physical ability to "absorb" the intervention, the challenges of co-worker instability and interpersonal relationships, and balancing extra workplace demands. The findings demonstrate the value of ethnographic approaches in community-based intervention research.
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Planning for the Mercy Center for Breast Health.
Olivares, V Ed
2002-01-01
During the last months of 2000, administrators at the Mercy San Juan Medical Center in Carmichael, Calif., convened a steering committee to plan the Mercy Center for Breast Health. The Steering Committee was composed of the director of ancillary and support services, the oncology clinical nurse specialist, the RN manager of the oncology nursing unit, the RN surgery center manager, and me, the manager of imaging services. The committee was responsible for creating a new business with five specific objectives: to position the Center as a comprehensive diagnostic and resource center for women; to generate physician referrals to the Breast Center through various vehicles; to create awareness of the Breast Center's capabilities among area radiologists; to create awareness of the Breast Center among employees of six sister facilities; to create "brand awareness" for the Mercy Center for Breast Health among referring physicians and patients who could use competing centers in the area. The Steering Committee's charter was to design a center with a feminine touch and ambience and to provide a "one-stop shopping" experience for patients. A major component of the Breast Center is the Dianne Haselwood Resource Center, which provides patients with educational support and information. The Steering Committee brought its diverse experience and interests to bear on arranging for equipment acquisition, information and clerical systems, staffing, clinic office design, patient care and marketing. Planning the Mercy Center for Breast Health has been a positive challenge that brought together many elements of the organization and people from different departments and specialties to create a new business venture. Our charge now is to grow and to live up to our vision of offering complete breast diagnostic, education and support services in one location.
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UNDER-UTILIZATION OF COMMUNITY HEALTH CENTERS IN PURWOREJO REGENCY, CENTRAL JAVA
Atik Triratnawati
2006-01-01
The basic strategy of the Ministry of Health to achieve Health For All In Indonesia 2010 is through health paradigm, decentralization, professionalism and health service management. Community health centers play an important role to achieve the goal. Unfortunately, underutilization of community health centers is still a problem in Purworejo. The purpose of this study was to know the utilization of community health centers using a sociological health approach. Qualitative research by observati...
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Carter, Martha
2012-01-01
Midwives are working in federally funded health centers in increasing numbers. Health centers provide primary and preventive health care to almost 20 million people and are located in every US state and territory. While health centers serve the entire community, they also serve as a safety net for low-income and uninsured individuals. In 2010, 93% of health center patients had incomes below 200% of the Federal Poverty Guidelines, and 38% were uninsured. Health centers, including community health centers, migrant health centers, health care for the homeless programs, and public housing primary care programs, receive grant funding and enjoy other benefits due to status as federal grantees and designation as federally qualified health centers. Clinicians working in health centers are also eligible for financial and professional benefits because of their willingness to serve vulnerable populations and work in underserved areas. Midwives, midwifery students, and faculty working in, or interacting with, health centers need to be aware of the regulations that health centers must comply with in order to qualify for and maintain federal funding. This article provides an overview of health center regulations and policies affecting midwives, including health center program requirements, scope of project policy, provider credentialing and privileging, Federal Tort Claims Act malpractice coverage, the 340B Drug Pricing Program, and National Health Service Corps scholarship and loan repayment programs. © 2012 by the American College of Nurse-Midwives.
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Center for Maritime Safety and Health Studies
Federal Laboratory Consortium — Established in November 2015, the Center for Maritime Safety and Health Studies (CMSHS) promotes safety and health for all maritime workers, including those employed...
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Health professionals’ experiences of person-centered collaboration in mental health care
Directory of Open Access Journals (Sweden)
Rita Sommerseth
2008-10-01
Full Text Available Rita Sommerseth, Elin DysvikUniversity of Stavanger, Faculty of Social Sciences, Department of Health Studies, Stavanger, NorwayObjective: The basic aim in this paper is to discuss health care professionals’ experiences of person-centered collaboration and involvement in mental health rehabilitation and suggest ways of improving this perspective. Furthermore, the paper explains the supportive systems that are at work throughout the process of rehabilitation.Method: The study design is a qualitative approach using three focus group interviews with a total of 17 informants with different professional backgrounds such as nurses, social workers, and social pedagogies. In addition, one nurse and one social worker participated in a semistructured in-depth interview to judge validity.Results: Our results may demonstrate deficits concerning mental health care on several levels. This understanding suggests firstly, that a person-centered perspective and involvement still are uncommon. Secondly, multidisciplinary work seems uncommon and only sporadically follows recommendations. Thirdly, family support is seldom involved. Lastly, firm leadership and knowledge about laws and regulations seems not to be systematically integrated in daily care.Conclusion: Taking these matters together, the improvement of a person-centered perspective implies cooperation between different services and levels in mental health care. In order to bring about improvement the health care workers must critically consider their own culture, coordination of competence must be increased, and leadership at an institutional and organizational level must be improved so that scarce rehabilitation resources are used to the optimal benefit of people with a mental illness.Keywords: multidisciplinary teams, person-centered collaboration, supportive systems, rehabilitation
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Maternal health service utilization in urban slums of selected towns ...
African Journals Online (AJOL)
Maternal health service utilization in urban slums of selected towns in Ethiopia: Qualitative study. ... Reasons were found to be attributed to individual characteristics, perceived capacities of health facilities and friendliness of service providers and socio-cultural factors including socially sanctioned expectations at community ...
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Directory of Open Access Journals (Sweden)
Tayyab Ikram Shah
Full Text Available Urban environments can influence many aspects of health and well-being and access to health care is one of them. Access to primary health care (PHC in urban settings is a pressing research and policy issue in Canada. Most research on access to healthcare is focused on national and provincial levels in Canada; there is a need to advance current understanding to local scales such as neighbourhoods.This study examines spatial accessibility to family physicians using the Three-Step Floating Catchment Area (3SFCA method to identify neighbourhoods with poor geographical access to PHC services and their spatial patterning across 14 Canadian urban settings. An index of spatial access to PHC services, representing an accessibility score (physicians-per-1000 population, was calculated for neighborhoods using a 3km road network distance. Information about primary health care providers (this definition does not include mobile services such as health buses or nurse practitioners or less distributed services such as emergency rooms used in this research was gathered from publicly available and routinely updated sources (i.e. provincial colleges of physicians and surgeons. An integrated geocoding approach was used to establish PHC locations.The results found that the three methods, Simple Ratio, Neighbourhood Simple Ratio, and 3SFCA that produce City level access scores are positively correlated with each other. Comparative analyses were performed both within and across urban settings to examine disparities in distributions of PHC services. It is found that neighbourhoods with poor accessibility scores in the main urban settings across Canada have further disadvantages in relation to population high health care needs.The results of this study show substantial variations in geographical accessibility to PHC services both within and among urban areas. This research enhances our understanding of spatial accessibility to health care services at the neighbourhood
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Directory of Open Access Journals (Sweden)
Joanna Vearey
2011-06-01
Full Text Available This article is a review of the PhD thesis undertaken by Joanna Vearey that explores local government responses to the urban health challenges of migration, informal settlements, and HIV in Johannesburg, South Africa. Urbanisation in South Africa is a result of natural urban growth and (to a lesser extent in-migration from within the country and across borders. This has led to the development of informal settlements within and on the periphery of urban areas. The highest HIV prevalence nationally is found within urban informal settlements. South African local government has a ‘developmental mandate’ that calls for government to work with citizens to develop sustainable interventions to address their social, economic, and material needs. Through a mixed-methods approach, four studies were undertaken within inner-city Johannesburg and a peripheral urban informal settlement. Two cross-sectional surveys – one at a household level and one with migrant antiretroviral clients – were supplemented with semi-structured interviews with multiple stakeholders involved with urban health and HIV in Johannesburg, and participatory photography and film projects undertaken with urban migrant communities. The findings show that local government requires support in developing and implementing appropriate intersectoral responses to address urban health. Existing urban health frameworks do not deal adequately with the complex health and development challenges identified; it is essential that urban public health practitioners and other development professionals in South Africa engage with the complexities of the urban environment. A revised, participatory approach to urban health – ‘concept mapping’ – is suggested which requires a recommitment to intersectoral action, ‘healthy urban governance’ and public health advocacy.
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Vearey, Joanna
2011-01-01
This article is a review of the PhD thesis undertaken by Joanna Vearey that explores local government responses to the urban health challenges of migration, informal settlements, and HIV in Johannesburg, South Africa. Urbanisation in South Africa is a result of natural urban growth and (to a lesser extent) in-migration from within the country and across borders. This has led to the development of informal settlements within and on the periphery of urban areas. The highest HIV prevalence nationally is found within urban informal settlements. South African local government has a ‘developmental mandate’ that calls for government to work with citizens to develop sustainable interventions to address their social, economic, and material needs. Through a mixed-methods approach, four studies were undertaken within inner-city Johannesburg and a peripheral urban informal settlement. Two cross-sectional surveys – one at a household level and one with migrant antiretroviral clients – were supplemented with semi-structured interviews with multiple stakeholders involved with urban health and HIV in Johannesburg, and participatory photography and film projects undertaken with urban migrant communities. The findings show that local government requires support in developing and implementing appropriate intersectoral responses to address urban health. Existing urban health frameworks do not deal adequately with the complex health and development challenges identified; it is essential that urban public health practitioners and other development professionals in South Africa engage with the complexities of the urban environment. A revised, participatory approach to urban health – ‘concept mapping’ – is suggested which requires a recommitment to intersectoral action, ‘healthy urban governance’ and public health advocacy. PMID:21686331
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2010-07-08
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Center for Health Statistics (NCHS), Classifications and Public Health Data Standards Staff, Announces the... Prevention, Classifications and Public Health Data Standards, 3311 Toledo Road, Room 2337, Hyattsville, MD...
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2013-08-28
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Center for Health Statistics (NCHS), Classifications and Public Health Data Standards Staff, Announces the... Administrator, Classifications and Public Health Data Standards Staff, NCHS, 3311 Toledo Road, Room 2337...
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2013-02-07
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Center for Health Statistics (NCHS), Classifications and Public Health Data Standards Staff, Announces the..., Medical Systems Administrator, Classifications and Public Health Data Standards Staff, NCHS, 3311 Toledo...
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42 CFR 405.2462 - Payment for rural health clinic and Federally qualified health center services.
2010-10-01
... integral and subordinate part of a hospital, skilled nursing facility or home health agency participating... 42 Public Health 2 2010-10-01 2010-10-01 false Payment for rural health clinic and Federally qualified health center services. 405.2462 Section 405.2462 Public Health CENTERS FOR MEDICARE & MEDICAID...
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Arokiasamy, P; Jain, Kshipra; Goli, Srinivas; Pradhan, Jalandhar
2013-03-01
As India rapidly urbanizes, within urban areas socioeconomic disparities are rising and health inequality among urban children is an emerging challenge. This paper assesses the relative contribution of socioeconomic factors to child health inequalities between the less developed Empowered Action Group (EAG) states and more developed South Indian states in urban India using data from the 2005-06 National Family Health Survey. Focusing on urban health from varying regional and developmental contexts, socioeconomic inequalities in child health are examined first using Concentration Indices (CIs) and then the contributions of socioeconomic factors to the CIs of health variables are derived. The results reveal, in order of importance, pronounced contributions of household economic status, parent's illiteracy and caste to urban child health inequalities in the South Indian states. In contrast, parent's illiteracy, poor economic status, being Muslim and child birth order 3 or more are major contributors to health inequalities among urban children in the EAG states. The results suggest the need to adopt different health policy interventions in accordance with the pattern of varying contributions of socioeconomic factors to child health inequalities between the more developed South Indian states and less developed EAG states.
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2010-09-16
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Center for Health Statistics (NCHS), Classifications and Public Health Data Standards Staff, Announces the... Public Health Data Standards Staff, NCHS, 3311 Toledo Road, Room 2337, Hyattsville, Maryland 20782, e...
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Campbell, P C; Ebuehi, O M
2011-01-01
Job satisfaction implies doing a job one enjoys, doing it well, and being suitably rewarded for one' efforts. Several factors affect job satisfaction. To compare factors influencing job satisfaction amongst rural and urban primary health care workers in southwestern Nigeria. A cross sectional comparative study recruited qualified health workers selected by multi stage sampling technique from rural and urban health facilities in four local government areas (LGAs) of Ogun State in Southwestern Nigeria. Data were collected and analysed using Epi info V 3.5.1 RESULTS: The response rates were 88(88%) and 91(91%) respectively in the rural and urban areas. While urban workers derived satisfaction from availability of career development opportunities, materials and equipment, in their current job, rural workers derived satisfaction from community recognition of their work and improved staff relationship. Major de-motivating factors common to both groups were lack of supportive supervision, client-provider relationship and lack of in-service training. However more rural 74(84.1%) than urban 62(68.1%) health workers would prefer to continue working in their present health facilities (p=0.04). There was a statistically significant difference between the two groups in job satisfaction with respect to tools availability and career development opportunities (pfactors influencing job satisfaction between rural and urban healthcare workers. There is need for human resource policy to be responsive to the diverse needs of health workers particularly at the primary level.
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New York State Health Foundation grant helps health centers win federal expansion funds.
Sandman, David; Cozine, Maureen
2012-11-01
With approximately 1.2 million New Yorkers poised to gain health insurance coverage as a result of federal health reform, demand for primary care services is likely to increase greatly. The Affordable Care Act includes $11 billion in funding to enhance primary care access at community health centers. Recognizing a need and an opportunity, in August 2010 the New York State Health Foundation made a grant of nearly $400,000 to the Community Health Care Association of New York State to work with twelve health centers to develop successful proposals for obtaining and using these federal funds. Ultimately, eleven of the twelve sites are expected to receive $25.6 million in federal grants over a five-year period-a sixty-four-fold return on the foundation's investment. This article describes the strategy for investing in community health centers; identifies key project activities, challenges, and lessons; and highlights its next steps for strengthening primary care.
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Public health evaluation of waste management plan of urban areas of Florence
International Nuclear Information System (INIS)
Corti, Andrea; Lombardi, Lidia; Carpentieri, Matteo; Buiatti, Eva; Bartolacci, Simone; Bianchi, Fabrizio; Linzalone, Nunzia; Minichilli, Fabrizio; Mancuso, Stefano
2005-01-01
Public health evaluation impact for solid municipal waste management of Florence urban areas is considered. In this case study the evaluation step of screening show the environmental analysis of pollutants in the urban areas and epidemiologic study of exposed population in the area
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Creating and validating GIS measures of urban design for health research.
Purciel, Marnie; Neckerman, Kathryn M; Lovasi, Gina S; Quinn, James W; Weiss, Christopher; Bader, Michael D M; Ewing, Reid; Rundle, Andrew
2009-12-01
Studies relating urban design to health have been impeded by the unfeasibility of conducting field observations across large areas and the lack of validated objective measures of urban design. This study describes measures for five dimensions of urban design - imageability, enclosure, human scale, transparency, and complexity - created using public geographic information systems (GIS) data from the US Census and city and state government. GIS measures were validated for a sample of 588 New York City block faces using a well-documented field observation protocol. Correlations between GIS and observed measures ranged from 0.28 to 0.89. Results show valid urban design measures can be constructed from digital sources.
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Directory of Open Access Journals (Sweden)
Jiazhi Zeng
Full Text Available China is facing the unprecedented challenge of rapidly increasing rural-to-urban migration. Migrants are in a vulnerable state when they attempt to access to primary care services. This study was designed to explore rural-to-urban migrants' experiences in primary care, comparing their quality of primary care experiences under different types of medical institutions in Guangzhou, China.The study employed a cross-sectional survey of 736 rural-to-urban migrants in Guangzhou, China in 2014. A validated Chinese version of Primary Care Assessment Tool--Adult Short Version (PCAT-AS, representing 10 primary care domains was used to collect information on migrants' quality of primary care experiences. These domains include first contact (utilization, first contact (accessibility, ongoing care, coordination (referrals, coordination (information systems, comprehensiveness (services available, comprehensiveness (services provided, family-centeredness, community orientation and culturally competent. These measures were used to assess the quality of primary care performance as reported from patients' perspective. Analysis of covariance was conducted for comparison on PCAT scores among migrants accessing primary care in tertiary hospitals, municipal hospitals, community health centers/community health stations, and township health centers/rural health stations. Multiple linear regression models were used to explore factors associated with PCAT total scores.After adjustments were made, migrants accessing primary care in tertiary hospitals (25.49 reported the highest PCAT total scores, followed by municipal hospitals (25.02, community health centers/community health stations (24.24, and township health centers/rural health stations (24.18. Tertiary hospital users reported significantly better performance in first contact (utilization, first contact (accessibility, coordination (information system, comprehensiveness (service available, and cultural competence
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Smit, Warren; Hancock, Trevor; Kumaresen, Jacob; Santos-Burgoa, Carlos; Sánchez-Kobashi Meneses, Raúl; Friel, Sharon
2011-10-01
The importance of reestablishing the link between urban planning and public health has been recognized in recent decades; this paper focuses on the relationship between urban planning/design and health equity, especially in cities in low and middle-income countries (LMICs). The physical urban environment can be shaped through various planning and design processes including urban planning, urban design, landscape architecture, infrastructure design, architecture, and transport planning. The resultant urban environment has important impacts on the health of the people who live and work there. Urban planning and design processes can also affect health equity through shaping the extent to which the physical urban environments of different parts of cities facilitate the availability of adequate housing and basic infrastructure, equitable access to the other benefits of urban life, a safe living environment, a healthy natural environment, food security and healthy nutrition, and an urban environment conducive to outdoor physical activity. A new research and action agenda for the urban environment and health equity in LMICs should consist of four main components. We need to better understand intra-urban health inequities in LMICs; we need to better understand how changes in the built environment in LMICs affect health equity; we need to explore ways of successfully planning, designing, and implementing improved health/health equity; and we need to develop evidence-based recommendations for healthy urban planning/design in LMICs.
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Economic Segmentation and Health Inequalities in Urban Post-Reform China
Directory of Open Access Journals (Sweden)
Soyoung Kwon
2016-08-01
Full Text Available During economic reform, Chinese economic labor markets became segmented by state sector associated with a planned redistributive economy and private sector associated with the market economy. By considering an economic sector as a concrete institutional setting in post-reform China, this paper compares the extent to which socioeconomic status, measured by education and income, is associated with self-rated health between state sector and private sector. The sample is limited to urban Chinese employees between the ages of 18 and 55 who were active in the labor force. By analyzing pooled data from the 1991–2006 Chinese Health and Nutrition Survey, I find that there is a stronger association between income and self-rated health in the private sector than in the state sector. This study suggests that sectoral differences between market and redistributive economies are an important key to understanding health inequalities in post-reform urban China.
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Kennedy Space Center environmental health program
International Nuclear Information System (INIS)
Marmaro, G.M.; Cardinale, M.A.; Summerfield, B.R.; Tipton, D.A.
1992-01-01
The Kennedy Space Center's environmental health organization is responsible for programs which assure its employees a healthful workplace under diverse and varied working conditions. These programs encompass the disciplines of industrial hygiene, radiation protection (health physics), and environmental sanitation/pollution control. Activities range from the routine, such as normal office work, to the highly specialized, such as the processing of highly toxic and hazardous materials
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Position of social determinants of health in urban man-made lakes plans.
Shojaei, Parisa; Karimloo, Masoud; Mohammadi, Farahnaz; Malek Afzali, Hossein; Forouzan, Ameneh Setareh
2013-09-04
A social determinants approach proposes that enhancing living conditions in areas such as income, housing, transportation, employment, education, social support, and health services is central to improving the health of urban populations. Urban development projects can be costly but have health impacts. The benefit derived from the creation of man-made lakes in developing countries is usually associated with great risks; however, the evidence for physical and non-physical health benefits of urban man-made lake is unclear. The aim of this paper is to formulate a conceptual framework of associations between urban man-made lakes and social determinants of health. This study was a qualitative study carried out using one focus group discussion and 16 individual interviews. Data were analyzed based on deductive-inductive content analysis approach. Participants' points of view were analyzed within 261 codes. Data analysis matrix was the conceptual framework of social determinants of health commission and its sub-groups, thus, two structural and mediating determinants categories as well as their sub-sets were created accordingly. In addition, some extra sub-sets including environment, air quality, weather changes, noise pollution, pathogenesis, quality of life, shortage of available resources, region popularity, ethnicity, tourism, social and physical development of children, unintentional injuries, aesthetic, and spirituality were extracted beyond the matrix factors, which were placed in each of above categories based on their thematic content. This paper has illustrated that the quality and type of man-made lake provided within communities can have a significant and sustained impact on community's health and wellbeing. Therefore, in order to strengthen positive effects and reduce negative effects of any developmental projects within community, their impacts on public health should be taken into consideration.
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Nature-based strategies for improving urban health and safety
Michelle C. Kondo; Eugenia C. South; Charles C. Branas
2015-01-01
Place-based programs are being noticed as key opportunities to prevent disease and promote public health and safety for populations at-large. As one key type of place-based intervention, nature-based and green space strategies can play an especially large role in improving health and safety for dwellers in urban environments such as US legacy cities that lack nature...
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Patient-centered medical home model: do school-based health centers fit the model?
Larson, Satu A; Chapman, Susan A
2013-01-01
School-based health centers (SBHCs) are an important component of health care reform. The SBHC model of care offers accessible, continuous, comprehensive, family-centered, coordinated, and compassionate care to infants, children, and adolescents. These same elements comprise the patient-centered medical home (PCMH) model of care being promoted by the Affordable Care Act with the hope of lowering health care costs by rewarding clinicians for primary care services. PCMH survey tools have been developed to help payers determine whether a clinician/site serves as a PCMH. Our concern is that current survey tools will be unable to capture how a SBHC may provide a medical home and therefore be denied needed funding. This article describes how SBHCs might meet the requirements of one PCMH tool. SBHC stakeholders need to advocate for the creation or modification of existing survey tools that allow the unique characteristics of SBHCs to qualify as PCMHs.
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Johnson Space Center Health and Medical Technical Authority
Fogarty, Jennifer A.
2010-01-01
1.HMTA responsibilities: a) Assure program/project compliance with Agency health and medical requirements at identified key decision points. b) Certify that programs/projects comply with Agency health and medical requirements prior to spaceflight missions. c) Assure technical excellence. 2. Designation of applicable NASA Centers for HMTA implementation and Chief Medical Officer (CMO) appointment. 3. Center CMO responsible for HMTA implementation for programs and projects at the center. JSC HMTA captured in "JSC HMTA Implementation Plan". 4. Establishes specifics of dissenting opinion process consistent with NASA procedural requirements.
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Ethiopia's urban primary health care reform: Practices, lessons, and ...
African Journals Online (AJOL)
Yayeh
to assess the implementation of the pilot initiatives. ... Keywords:- Urban, health extension professionals, PHC, pilot. Background. The history of .... The FHT is divided into two sub-teams. .... helped in drawing attention to social sectors that were.
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Utilization of Mental Health Services in School-Based Health Centers.
Bains, Ranbir M; Cusson, Regina; White-Frese, Jesse; Walsh, Stephen
2017-08-01
We summarize utilization patterns for mental health services in school-based health centers. Administrative data on school-based health center visits in New Haven, Connecticut were examined for the 2007-2009 school years. Relative frequencies of mental health visits by age were calculated as a percentage of all visits and were stratified by sex, ethnicity/race, and insurance status. Mental health visits accounted for the highest proportion of visits (31.8%). The proportion of mental health visits was highest at 8 years (42.8%) and at 13 years (39.0%). The proportion of mental health visits among boys (38.4%) was higher than among girls (26.7%). Hispanic students had a lower proportion of mental health visits than black students (23.5% vs 35.8%) in all but 2 age groups. Students in the white/other ethnicity category had higher proportions of mental health visits than Hispanic and black students between ages 12 and 15. Students with no health insurance (22.5%) had lower proportions of mental health visits than students covered by Medicaid (34.3%) or private insurance (33.9%). The percentage of mental health visits by students with private insurance was highest (37.2%-49%) in the 13-15 age range. Usage patterns for mental health issues show pronounced, nonrandom variation relative to age and other demographic characteristics especially with 8-year-old boys. © 2017, American School Health Association.
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UNDER-UTILIZATION OF COMMUNITY HEALTH CENTERS IN PURWOREJO REGENCY, CENTRAL JAVA
Directory of Open Access Journals (Sweden)
Atik Triratnawati
2006-06-01
Full Text Available The basic strategy of the Ministry of Health to achieve Health For All In Indonesia 2010 is through health paradigm, decentralization, professionalism and health service management. Community health centers play an important role to achieve the goal. Unfortunately, underutilization of community health centers is still a problem in Purworejo. The purpose of this study was to know the utilization of community health centers using a sociological health approach. Qualitative research by observation, in-depth interview and focus group discussion were done among different types of group. The study was done in Purworejo District on February and March 2000. The main problems related to underutilization of community health centers are mostly on administration (less quality services, un-efficient, long hours waiting, strong bureaucratic system (physician has a dominant power, overlapping programs, poor coordination and integration with other divisions and cultural behavior of the community (labeling/stigma, self-care dominant, lack of community participation. To overcome under-utilization of community health centers the administration and bureaucracy should be changed into more efficient, not bureaucratic management. In addition social changes of the community culture is needed. As a consequence through these changes the staff of the health centers will be more efficient and effective.
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Urban Public Health: Is There a Pyramid?
Directory of Open Access Journals (Sweden)
Meirong Su
2013-01-01
Full Text Available Early ecologists identified a pyramidal trophic structure in terms of number, biomass and energy transfer. In 1943, the psychologist Maslow put forward a pyramid model to describe layers of human needs. It is indicated that the pyramid principle is universally applicable in natural, humanistic and social disciplines. Here, we report that a pyramid structure also exists in urban public health (UPH. Based on 18 indicators, the UPH states of four cities (Beijing, Tokyo, New York, and London are compared from the point of view of five aspects, namely physical health, living conditions, social security, environmental quality, and education and culture. A pyramid structure was found in each city when focusing on 2000–2009 data. The pyramid of Beijing is relatively similar to that of Tokyo, and the pyramids of New York and London are similar to each other. A general development trend in UPH is proposed and represented by different pyramid modes. As a basic conjecture, the UPH pyramid model can be verified and developed with data of more cities over a longer period, and be used to promote healthy urban development.
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The Oral Health Care Manager in a Patient-Centered Health Facility.
Theile, Cheryl Westphal; Strauss, Shiela M; Northridge, Mary Evelyn; Birenz, Shirley
2016-06-01
The dental hygienist team member has an opportunity to coordinate care within an interprofessional practice as an oral health care manager. Although dental hygienists are currently practicing within interprofessional teams in settings such as pediatric offices, hospitals, nursing homes, schools, and federally qualified health centers, they often still assume traditional responsibilities rather than practicing to the full extent of their training and licenses. This article explains the opportunity for the dental hygiene professional to embrace patient-centered care as an oral health care manager who can facilitate integration of oral and primary care in a variety of health care settings. Based on an innovative model of collaboration between a college of dentistry and a college of nursing, an idea emerged among several faculty members for a new management method for realizing continuity and coordination of comprehensive patient care. Involved faculty members began working on the development of an approach to interprofessional practice with the dental hygienist serving as an oral health care manager who would address both oral health care and a patient's related primary care issues through appropriate referrals and follow-up. This approach is explained in this article, along with the results of several pilot studies that begin to evaluate the feasibility of a dental hygienist as an oral health care manager. A health care provider with management skills and leadership qualities is required to coordinate the interprofessional provision of comprehensive health care. The dental hygienist has the opportunity to lead closer integration of oral and primary care as an oral health care manager, by coordinating the team of providers needed to implement comprehensive, patient-centered care. Copyright © 2016 Elsevier Inc. All rights reserved.
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ENEL high and medium voltage electrical substations for power supply to urban centers
International Nuclear Information System (INIS)
Bargigia, A.; Boatto, C.; Di Mario, A.; Fava, N.; Sciarra, S.; Speziali, R.
1991-12-01
Modular high and medium voltage gas insulated electrical substations are being used by ENEL (Italian Electricity Board) to meet the specific needs of urban centers with special design and sizing constraints of a historical/architectural nature. This paper illustrates the key design, construction operation and performance characteristics of these standardized units. The descriptions include brief notes on equipment-transformer interconnection, interchangeability and environmental compatibility. Performance test procedures and results of actual reliability and certification tests on some substations are reported
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National Center for Disaster Medicine and Public Health
Federal Laboratory Consortium — The National Center for Disaster Medicine and Public Health (NCDMPH) is an academic center tasked with leading federal, and coordinating national, efforts to develop...
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Directory of Open Access Journals (Sweden)
M. Asadi
2014-10-01
Full Text Available Introduction & Objective: Cryptosporidium is one of the most important zoonotic and oppor-tunistic protozoa and can cause diarrhea in those with impaired immune systems, as well as the children. Considering the high sensitivity of children against infection caused by crypto-sporidium, its zoonotic nature and lack of treatment, this study aimed to determine the prevalence of cryptosporidium infection in children under 10 years old, referred to the health care centers of Hamadan district. Materials & Methods: This study was conducted in 2013 on 420 children (222 males and 198 females, who were referred to urban and rural health care centers in Hamadan district. Stool samples were examined using formalin-ether method and modified Ziehl-Neelsen staining technique. The results were analyzed with chi-square test. Results: Of the 420 children studied, 2 individuals (0.47% (A 16-month-old boy and a 6-year-old girl were infected with cryptosporidium spp. The infection was observed only in rural areas and in children that were in direct contact with the animals. Conclusion: The results of this study showed a presence of cryptosporidium in rural areas compared to urban areas and in children in contact with animals. Therefore it is necessary to promote the public health awareness of rural population. (Sci J Hamadan Univ Med Sci 2014; 21 (3: 211-217
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County-level poverty is equally associated with unmet health care needs in rural and urban settings.
Peterson, Lars E; Litaker, David G
2010-01-01
Regional poverty is associated with reduced access to health care. Whether this relationship is equally strong in both rural and urban settings or is affected by the contextual and individual-level characteristics that distinguish these areas, is unclear. Compare the association between regional poverty with self-reported unmet need, a marker of health care access, by rural/urban setting. Multilevel, cross-sectional analysis of a state-representative sample of 39,953 adults stratified by rural/urban status, linked at the county level to data describing contextual characteristics. Weighted random intercept models examined the independent association of regional poverty with unmet needs, controlling for a range of contextual and individual-level characteristics. The unadjusted association between regional poverty levels and unmet needs was similar in both rural (OR = 1.06 [95% CI, 1.04-1.08]) and urban (OR = 1.03 [1.02-1.05]) settings. Adjusting for other contextual characteristics increased the size of the association in both rural (OR = 1.11 [1.04-1.19]) and urban (OR = 1.11 [1.05-1.18]) settings. Further adjustment for individual characteristics had little additional effect in rural (OR = 1.10 [1.00-1.20]) or urban (OR = 1.11 [1.01-1.22]) settings. To better meet the health care needs of all Americans, health care systems in areas with high regional poverty should acknowledge the relationship between poverty and unmet health care needs. Investments, or other interventions, that reduce regional poverty may be useful strategies for improving health through better access to health care. © 2010 National Rural Health Association.
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Governance for Urban Health Equity: Mobilizing Demand for Primary ...
International Development Research Centre (IDRC) Digital Library (Canada)
Home · What we do ... New research will identify opportunities to improve health care for the urban poor and involve communities ... Addressing this governance crisis will be paramount to improving service delivery for slum residents and to ...
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View from the center: Supercities conference
Knox, J. B.
The Supercities Conference (26-30 October 1992) was the initial activity planned and executed by the Pacific Basin Study Center (PBSC), a research center founded by San Francisco State University and the University of California, Davis. The Conference focused on issues of environmental quality and the quest for sustainable development in the great urban centers—Supercities—of the Pacific. The Conference, with its working group process, highlighted the long-term commitment of the PBSC to education, training, and research in regard to environmental, energy, and resource utilization issues that challenge society now and the coming century. We define a "Supercity" as a large metropolitan area of about eight million population currently undergoing rapid growth in population and urbanization. Some of the cities considered at the conference are emerging "Supercities"—large urban complexes destined to soon be "Supercities". Supercities in both the developing and developed nations are at critical stages of development, with the size and number of Supercities appearing to be unstoppable. These urban centers and their surrounding areas are large users of resources and energy. In many cases, the national demand for energy and materials will be largely patterned by the strategies, management, and actions taken within the Supercities. It is for this reason that our focus is on these dynamic, urban entities of the Pacific. Appropriate technology transfer, sharing of common concerns and knowledge, and the seeking of workable conservation and remediation efforts within Supercities could improve living conditions within these centers, and address regional and global environmental issues in parallel. The Conference focused on urban air quality conditions in 14 metropolitan areas, common health impacts, and projected emissions; a working group process defined needed areas for research and development of key information. Through the medium of panels, the progress of several major
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HEALTH OF URBAN POPULATION IN MOSCOW AND BEIJING AGGLOMERETIONS
Directory of Open Access Journals (Sweden)
Svetlana M. Malkhazova
2014-01-01
Full Text Available The paper presents the results obtained under the joint Russian-Chinese RFBR project № 12-05-91175-ГФЕН_а aimed at assessment of the state of the environment and health of the population in urban areas in Russia and China. The paper presents the authors’ approach to a comprehensive evaluation of the impact of the environment on the populationhealth of urban agglomerations and a method of regional medico-geographical analysis. A series of analytical and synthetic maps was compiled and used for a comparative geographical analysis of medical and environmental situation in Moscow and Beijing – major metropolitan areas with different natural and socio-economic conditions. The paper discusses the influence of the environment on the state of public health and identifies the leading risk factors, both general and specific to each region.
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Cohen, Steven A; Cook, Sarah K; Sando, Trisha A; Sabik, Natalie J
2017-11-29
Rural-urban health disparities are well-documented and particularly problematic for older adults. However, determining which specific aspects of rural or urban living initiate these disparities remains unclear. The purpose of this study was to assess associations between place-based characteristics of rural-urban status and health among adults age 65+. Data from the 2012 Behavioral Risk Factor Surveillance System were geographically linked to place-based characteristics from the American Community Survey. Self-reported health (SRH), obesity, and health checkup within the last year were modeled against rural-urban status (distance to nearest metropolitan area, population size, population density, percent urban, Urban Influence Codes [UIC], Rural-Urban Continuum Codes [RUCC], and Rural-Urban Commuting Area [RUCA]) using generalized linear models, accounting for covariates and complex sampling, overall, and stratified by area-level income. In general, increasing urbanicity was associated with a reduction in negative SRH for all 7 measures of rural-urban status. For low-income counties, this association held for all measures and characteristics of rural-urban status except population density. However, for high-income counties, the association was reversed-respondents living in areas of increasing urbanicity were more likely to report negative SRH for 4 of the 7 measures (RUCC, UIC, RUCA, and percent urban). Findings were mixed for the outcome of obesity, where rural areas had higher levels, except in low-income counties, where the association between rurality and obesity was reversed (OR 1.033, 95%CI: 1.002-1.064). These results suggest that rural-urban status is both a continuum and multidimensional. Distinct elements of rural-urban status may influence health in nuanced ways that require additional exploration in future studies. © 2017 National Rural Health Association.
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The role of health centers in preventive care provision
Directory of Open Access Journals (Sweden)
Shemetova G.N.
2017-12-01
Full Text Available Aim: to assess the importance of the Centers of Health in the organization and provision of preventive care to the population, in the early detection of risk factors for the development of chronic non-communicable diseases and the development of a healthy lifestyle. Material and Methods. On the basis of the Health Center of Engels Center for Medical Prevention in the Saratov Region, the detection of risk factors for 2011-2015 was analyzed according to statistical reporting (form No. 68 and health cards (form025-CZ/y of 207 patients. To assess the satisfaction of visitors with the work of the Center, a specially developed questionnaire was conducted, which included 22 questions that characterize the patient profile, his attitude to the organization and the results of the survey, and the motivation to modify the way of life. Results. The study confirmed the important role of the Centers of Health in the organization and provision of preventive care to the population, the formation of a healthy lifestyle and the early detection of diseases and risk factors for their development. Conclusion. Only joint efforts of medical institutions, authorities, educational organizations, mass media can lead to the formation of the population's responsibility for their health and readiness to modify the way of life.
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Attitude toward mental illness amongst urban nonpsychiatric health professionals
Directory of Open Access Journals (Sweden)
V Pande
2011-01-01
Full Text Available Background: This study was designed to examine the attitude of nonpsychiatric health professionals about mental illness in urban multispeciality tertiary care setting. Aim: To assess attitude toward mental illness among urban nonpsychiatric health professionals. Materials and Methods: A cross-sectional study design was used. A pretested, semistructured questionnaire was administered to 222 medical and paramedical staff at two tertiary care hospitals at Chandigarh. Results: There is an increased awareness of mental illness especially in military subjects. Literacy was associated with a positive attitude toward mental illness. Health care givers commonly fail to ask about the emotional well being of their patients. Many saw referral to psychiatrist as a form of punishment. There is uniform desire for more knowledge about psychiatric disorders in medical and paramedical staff. Conclusions: This study demonstrates the need for educational programs aimed at demystifying mental illness. A better understanding of mental disorders among the nonpsychiatric medical professional would help to allay fear and mistrust about mentally ill persons in the community as well as lessen stigmatization toward such persons.
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Goli, Srinivas; Doshi, Riddhi; Perianayagam, Arokiasamy
2013-01-01
BACKGROUND/OBJECTIVE: Children and women comprise vulnerable populations in terms of health and are gravely affected by the impact of economic inequalities through multi-dimensional channels. Urban areas are believed to have better socioeconomic and maternal and child health indicators than rural areas. This perception leads to the implementation of health policies ignorant of intra-urban health inequalities. Therefore, the objective of this study is to explain the pathways of economic inequa...
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Muntaner, Carles; Chung, Haejoo; Murphy, Kelly; Ng, Edwin
2012-12-01
In this paper, we consider social forces that affect the processes of both knowledge production and knowledge translation in relation to urban health research. First, we briefly review our conceptual model, derived from a social-conflict framework, to outline how unequal power relations and health inequalities are causally linked. Second, we critically discuss ideological, political, and economic barriers that exist within academia that affect knowledge production related to urban health and health inequalities. Third, we broaden the scope of our analysis to examine how the ideological, political, and economic environment beyond the academy creates barriers to health equity policy making. We conclude with some key questions about the role that knowledge translation can possibly play in light of these constraints on research and policy for urban health.
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Urban Environmental Noise Pollution and Perceived Health Effects ...
African Journals Online (AJOL)
Urban environmental noise pollution has impact on the quality of life and it is a serious health and social problem. The aim of this study was to assess the sources and noise levels, and possible impacts in selected residential neighbourhoods of Ibadan metropolis. Structured questionnaire was used to elicit information from ...
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Relational aggression and adverse psychosocial and physical health symptoms among urban adolescents.
Williams, Jessica Roberts; Fredland, Nina; Han, Hae-Ra; Campbell, Jacquelyn C; Kub, Joan E
2009-01-01
The purpose of this study was to examine relational aggression and its relationship with adverse psychosocial and physical health symptoms among urban, African American youth. Quantitative, cross-sectional survey design. The sample consisted of 185 predominantly African American (95.1%) seventh-grade students (mean age: 13.0; female: 58%) attending 4 urban middle schools. The Children's Social Behavior Scale and Social Experience Questionnaire were used to measure relational aggression and relational victimization. The Pediatric Symptom Checklist was used to assess psychosocial difficulties, including internalizing behaviors, externalizing behaviors, and attention problems. Physical health symptoms were measured with questions about colds/flu, headaches, and stomach aches. 2-way multivariate analysis of variance revealed significant differences in externalizing behavior, with perpetrators reporting higher levels than nonperpetrators. Victims reported more internalizing behavior than nonvictims; however, this was only significant for males. For females, significant negative effects on health outcomes were found, resulting from the interaction of perpetration and victimization. Findings suggest that relational aggression is a common occurrence among urban, minority adolescents and may result in adverse health outcomes. These results provide several avenues for future research and implications for healthcare practice. Intervention strategies are needed to prevent relational aggression and continual or subsequent adverse health symptoms.
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Is sprawl associated with a widening urban-suburban mortality gap?
Fan, Yingling; Song, Yan
2009-09-01
This paper examines whether sprawl, featured by low development density, segregated land uses, lack of significant centers, and poor street connectivity, contributes to a widening mortality gap between urban and suburban residents. We employ two mortality datasets, including a national cross-sectional dataset examining the impact of metropolitan-level sprawl on urban-suburban mortality gaps and a longitudinal dataset from Portland examining changes in urban-suburban mortality gaps over time. The national and Portland studies provide the only evidence to date that (1) across metropolitan areas, the size of urban-suburban mortality gaps varies by the extent of sprawl: in sprawling metropolitan areas, urban residents have significant excess mortality risks than suburban residents, while in compact metropolitan areas, urbanicity-related excess mortality becomes insignificant; (2) the Portland metropolitan area not only experienced net decreases in mortality rates but also a narrowing urban-suburban mortality gap since its adoption of smart growth regime in the past decade; and (3) the existence of excess mortality among urban residents in US sprawling metropolitan areas, as well as the net mortality decreases and narrowing urban-suburban mortality gap in the Portland metropolitan area, is not attributable to sociodemographic variations. These findings suggest that health threats imposed by sprawl affect urban residents disproportionately compared to suburban residents and that efforts curbing sprawl may mitigate urban-suburban health disparities.
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Urban health in daily practice: livelihood, vulnerability and resilience in Dar es Salaam, Tanzania.
Obrist, Brigit
2003-12-01
Health is the core value and ultimate goal of health development, yet we know very little about health conceptions in everyday life. Inspired by investigations into lay health concepts in Europe, our study explores experiences and meanings of health in a strikingly different context, namely, in a low-income neighbourhood of an African city. Grounded in ethnographic research in Dar es Salaam, we introduce the concept of 'health practice' and examine health definitions, explanations, and activities of urban Swahili women. Our findings show that representations of health form a set of experiences, meanings and embodied practice centring on the links between body, mind, and living conditions. We suggest that 'livelihood', 'vulnerability' and 'resilience' best capture women's main concerns of health practice in such a setting. All women face an emotional burden of being exposed to urban afflictions and an intellectual and practical burden of overcoming them, but some meet this challenge more successfully than others do. This approach tips the balance towards a positive view of health that has been neglected in medical anthropology. It also opens new lines of inquiry in urban health research by consequently following a resource orientation that acknowledges women's struggle to stay healthy and directs attention to their agency.
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Directory of Open Access Journals (Sweden)
Gowda Giriyanna
2015-06-01
Full Text Available Objective: To assess awareness of link workers regarding dengue fever and its prevention and the effect of health education about dengue and its prevention. Methods: Prospective interventional study was conducted in selected urban health centers of Bengaluru. About 106 link workers selected by systematic random sampling were interviewed by trained investigators. Health education was given to all of them and awareness was reassessed after a gap of one month. Results: Mean age of link workers was (36.95 ± 5.88 years. A total of 49.06% of link workers were aware that dengue is caused by virus, 74.53% were aware of complications of dengue, 87.74 % were aware that dengue is spread by Aedes mosquito. After health education the above observations increased to 81.4%, 87.63%, and 90.72% respectively. Difference between mean preand post-test score was statistically significant (P < 0.05. Conclusions: Awareness regarding dengue fever and its prevention was poor among link workers, which improved significantly after health education.
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Goli, Srinivas; Doshi, Riddhi; Perianayagam, Arokiasamy
2013-01-01
Children and women comprise vulnerable populations in terms of health and are gravely affected by the impact of economic inequalities through multi-dimensional channels. Urban areas are believed to have better socioeconomic and maternal and child health indicators than rural areas. This perception leads to the implementation of health policies ignorant of intra-urban health inequalities. Therefore, the objective of this study is to explain the pathways of economic inequalities in maternal and child health indicators among the urban population of India. Using data from the third wave of the National Family Health Survey (NFHS, 2005-06), this study calculated relative contribution of socioeconomic factors to inequalities in key maternal and child health indicators such as antenatal check-ups (ANCs), institutional deliveries, proportion of children with complete immunization, proportion of underweight children, and Infant Mortality Rate (IMR). Along with regular CI estimates, this study applied widely used regression-based Inequality Decomposition model proposed by Wagstaff and colleagues. The CI estimates show considerable economic inequalities in women with less than 3 ANCs (CI = -0.3501), institutional delivery (CI = -0.3214), children without fully immunization (CI = -0.18340), underweight children (CI = -0.19420), and infant deaths (CI = -0.15596). Results of the decomposition model reveal that illiteracy among women and her partner, poor economic status, and mass media exposure are the critical factors contributing to economic inequalities in maternal and child health indicators. The residuals in all the decomposition models are very less; this implies that the above mentioned factors explained maximum inequalities in maternal and child health of urban population in India. Findings suggest that illiteracy among women and her partner, poor economic status, and mass media exposure are the critical pathways through which economic factors operate on inequalities in
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Directory of Open Access Journals (Sweden)
Srinivas Goli
Full Text Available BACKGROUND/OBJECTIVE: Children and women comprise vulnerable populations in terms of health and are gravely affected by the impact of economic inequalities through multi-dimensional channels. Urban areas are believed to have better socioeconomic and maternal and child health indicators than rural areas. This perception leads to the implementation of health policies ignorant of intra-urban health inequalities. Therefore, the objective of this study is to explain the pathways of economic inequalities in maternal and child health indicators among the urban population of India. METHODS: Using data from the third wave of the National Family Health Survey (NFHS, 2005-06, this study calculated relative contribution of socioeconomic factors to inequalities in key maternal and child health indicators such as antenatal check-ups (ANCs, institutional deliveries, proportion of children with complete immunization, proportion of underweight children, and Infant Mortality Rate (IMR. Along with regular CI estimates, this study applied widely used regression-based Inequality Decomposition model proposed by Wagstaff and colleagues. RESULTS: The CI estimates show considerable economic inequalities in women with less than 3 ANCs (CI = -0.3501, institutional delivery (CI = -0.3214, children without fully immunization (CI = -0.18340, underweight children (CI = -0.19420, and infant deaths (CI = -0.15596. Results of the decomposition model reveal that illiteracy among women and her partner, poor economic status, and mass media exposure are the critical factors contributing to economic inequalities in maternal and child health indicators. The residuals in all the decomposition models are very less; this implies that the above mentioned factors explained maximum inequalities in maternal and child health of urban population in India. CONCLUSION: Findings suggest that illiteracy among women and her partner, poor economic status, and mass media exposure are the critical
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The Community Mental Health Center as a Matrix Organization.
White, Stephen L.
1978-01-01
This article briefly reviews the literature on matrix organizational designs and discusses the ways in which the matrix design might be applied to the special features of a community mental health center. The phases of one community mental health center's experience in adopting a matrix organizational structure are described. (Author)
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Alhamdan, Adel A; Alshammari, Sulaiman A; Al-Amoud, Maysoon M; Hameed, Tariq A; Al-Muammar, May N; Bindawas, Saad M; Al-Orf, Saada M; Mohamed, Ashry G; Al-Ghamdi, Essam A; Calder, Philip C
2015-09-01
To evaluate the health care services provided for older adults by primary health care centers (PHCCs) in Riyadh, Kingdom of Saudi Arabia (KSA), and the ease of use of these centers by older adults. Between October 2013 and January 2014, we conducted a descriptive cross-sectional study of 15 randomly selected PHCCs in Riyadh City, KSA. The evaluation focused on basic indicators of clinical services offered and factors indicative of the ease of use of the centers by older adults. Evaluations were based upon the age-friendly PHCCs toolkit of the World Health Organization. Coverage of basic health assessments (such as blood pressure, diabetes, and blood cholesterol) was generally good. However, fewer than half of the PHCCs offered annual comprehensive screening for the common age-related conditions. There was no screening for cancer. Counseling on improving lifestyle was provided by most centers. However, there was no standard protocol for counseling. Coverage of common vaccinations was poor. The layout of most PHCCs and their signage were good, except for lack of Braille signage. There may be issues of access of older adults to PHCCs through lack of public transport, limited parking opportunities, the presence of steps, ramps, and internal stairs, and the lack of handrails. Clinical services and the internal environment of PHCCs can be improved. The data will be useful for health-policy makers to improve PHCCs to be more age-friendly.
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Directory of Open Access Journals (Sweden)
Adel A. Alhamdan
2015-09-01
Full Text Available Objectives: To evaluate the health care services provided for older adults by primary health care centers (PHCCs in Riyadh, Kingdom of Saudi Arabia (KSA, and the ease of use of these centers by older adults. Methods: Between October 2013 and January 2014, we conducted a descriptive cross-sectional study of 15 randomly selected PHCCs in Riyadh City, KSA. The evaluation focused on basic indicators of clinical services offered and factors indicative of the ease of use of the centers by older adults. Evaluations were based upon the age-friendly PHCCs toolkit of the World Health Organization. Results: Coverage of basic health assessments (such as blood pressure, diabetes, and blood cholesterol was generally good. However, fewer than half of the PHCCs offered annual comprehensive screening for the common age-related conditions. There was no screening for cancer. Counseling on improving lifestyle was provided by most centers. However, there was no standard protocol for counseling. Coverage of common vaccinations was poor. The layout of most PHCCs and their signage were good, except for lack of Braille signage. There may be issues of access of older adults to PHCCs through lack of public transport, limited parking opportunities, the presence of steps, ramps, and internal stairs, and the lack of handrails. Conclusions: Clinical services and the internal environment of PHCCs can be improved. The data will be useful for health-policy makers to improve PHCCs to be more age-friendly.
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Kalichman, Seth; Katner, Harold; Banas, Ellen; Kalichman, Moira
2017-07-01
AIDS stigmas delay HIV diagnosis, interfere with health care, and contribute to mental health problems among people living with HIV. While there are few studies of the geographical distribution of AIDS stigma, research suggests that AIDS stigmas are differentially experienced in rural and urban areas. We conducted computerized interviews with 696 men and women living with HIV in 113 different zip code areas that were classified as large-urban, small-urban, and rural areas in a southeast US state with high-HIV prevalence. Analyses conducted at the individual level (N = 696) accounting for clustering at the zip code level showed that internalized AIDS-related stigma (e.g., the sense of being inferior to others because of HIV) was experienced with greater magnitude in less densely populated communities. Multilevel models indicated that after adjusting for potential confounding factors, rural communities reported greater internalized AIDS-related stigma compared to large-urban areas and that small-urban areas indicated greater experiences of enacted stigma (e.g., discrimination) than large-urban areas. The associations between anticipated AIDS-related stigma (e.g., expecting discrimination) and population density at the community-level were not significant. Results suggest that people living in rural and small-urban settings experience greater AIDS-related internalized and enacted stigma than their counterparts living in large-urban centers. Research is needed to determine whether low-density population areas contribute to or are sought out by people who experienced greater AIDS-related stigma. Regardless of causal directions, interventions are needed to address AIDS-related stigma, especially among people in sparsely populated areas with limited resources.
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Oral health knowledge of health care workers in special children’s center
Wyne, Amjad; Hammad, Nouf; Splieth, Christian
2015-01-01
Objective: To determine the oral health knowledge of health care workers in special children’s center. Methods: A self-administered questionnaire was used to collect following information: demographics, oral hygiene practices, importance of fluoride, dental visits, cause of tooth decay, gingival health, and sources of oral health information. The study was conducted at Riyadh Center for Special Children in Riyadh City from December 2013 to May 2014. Results: All 60 health care workers in the center completed the questionnaire. A great majority (95%) of the workers brushed their teeth twice or more daily. More than two-third (71.7%) of the workers knew that fluoride helps in caries prevention. One in five (21.7%) workers thought that a dental visit only becomes necessary in case of a dental problem. Similarly, 13.3% of the workers thought to “wait till there is some pain in case of a dental cavity” before seeking dental treatment. The workers ranked soft drinks/soda (98.3%), flavored fizzy drinks (60%) and sweetened/flavored milks (43.3%) as top three cariogenic drinks. A great majority (95%) of the workers correctly responded that blood on toothbrush most probably is a sign of “gum disease”. Dentists (50%) and media (45%) were the main source of their oral health information. There was no significant difference (p > 0.05) in workers’ response in relation to their specific job. Conclusion: The special health care workers in the disabled children’s center generally had satisfactory oral health knowledge and practices. PMID:25878636
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Oral Health Inequalities between Rural and Urban Populations of the African and Middle East Region.
Ogunbodede, E O; Kida, I A; Madjapa, H S; Amedari, M; Ehizele, A; Mutave, R; Sodipo, B; Temilola, S; Okoye, L
2015-07-01
Although there have been major improvements in oral health, with remarkable advances in the prevention and management of oral diseases, globally, inequalities persist between urban and rural communities. These inequalities exist in the distribution of oral health services, accessibility, utilization, treatment outcomes, oral health knowledge and practices, health insurance coverage, oral health-related quality of life, and prevalence of oral diseases, among others. People living in rural areas are likely to be poorer, be less health literate, have more caries, have fewer teeth, have no health insurance coverage, and have less money to spend on dental care than persons living in urban areas. Rural areas are often associated with lower education levels, which in turn have been found to be related to lower levels of health literacy and poor use of health care services. These factors have an impact on oral health care, service delivery, and research. Hence, unmet dental care remains one of the most urgent health care needs in these communities. We highlight some of the conceptual issues relating to urban-rural inequalities in oral health, especially in the African and Middle East Region (AMER). Actions to reduce oral health inequalities and ameliorate rural-urban disparity are necessary both within the health sector and the wider policy environment. Recommended actions include population-specific oral health promotion programs, measures aimed at increasing access to oral health services in rural areas, integration of oral health into existing primary health care services, and support for research aimed at informing policy on the social determinants of health. Concerted efforts must be made by all stakeholders (governments, health care workforce, organizations, and communities) to reduce disparities and improve oral health outcomes in underserved populations. © International & American Associations for Dental Research 2015.
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Directory of Open Access Journals (Sweden)
Chen Yu
Full Text Available ABSTRACT With the acceleration of urbanization and industrialization, urban air pollution has become a serious threat to the health of urban residents. In this study, to investigate health hazards caused by air pollution for urban residents, concentrations of main air pollutants and annual coal consumption amounts during the period from 2000 to 2013 were analyzed. Our results showed that economic losses of Urumqi caused by air pollution amounted to 63.155 million yuan in 2013, accounting for 0.2 ‰ of its GDP and 5.7% of public utility expenditures for that year. The compensation mechanism analysis suggested that it is necessary to further improve the health care system and increase corporate environmental taxes. More environmental health protection taxes should be levied on key monitoredenterprises in Urumqi to achieve effective compensations for urban residents affected by air pollution-related health hazards.
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Improving the Neighborhood Environment for Urban Older Adults: Social Context and Self-Rated Health.
Mathis, Arlesia; Rooks, Ronica; Kruger, Daniel
2015-12-22
By 2030, older adults will account for 20% of the U.S. Over 80% of older adults live in urban areas. This study examines associations between neighborhood environment and self-rated health (SRH) among urban older adults. We selected 217 individuals aged 65+ living in a deindustrialized Midwestern city who answered questions on the 2009 Speak to Your Health survey. The relationship between neighborhood environment and self-rated health (SRH) was analyzed using regression and GIS models. Neighborhood variables included social support and participation, perceived racism and crime. Additional models included actual crime indices to compare differences between perceived and actual crime. Seniors who have poor SRH are 21% more likely to report fear of crime than seniors with excellent SRH (p = 0.01). Additional analyses revealed Black seniors are 7% less likely to participate in social activities (p = 0.005) and 4% more likely to report experiencing racism (p older adults living in urban neighborhoods, studies such as this one are important for well-being among seniors. Mitigating environmental influences in the neighborhood which are associated with poor SRH may allow urban older adults to maintain health and reduce disability.
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Duthé, Géraldine; Rossier, Clémentine; Bonnet, Doris; Soura, Abdramane Bassiahi; Corker, Jamaica
2016-01-01
In sub-Saharan African cities, the epidemiological transition has shifted a greater proportion of the burden of non-communicable diseases, including mental and behavioral disorder, to the adult population. The burden of major depressive disorder and its social risk factors in the urban sub-Saharan African population are not well understood and estimates vary widely. We conducted a study in Ouagadougou, Burkina Faso, in order to estimate the prevalence of major depressive episodes among adults in this urban setting. The Ouagadougou Health and Demographic System Site (HDSS) has followed the inhabitants of five outlying neighborhoods of the city since 2008. In 2010, a representative sample of 2,187 adults (aged 15 and over) from the Ouaga HDSS was interviewed in depth regarding their physical and mental health. Using criteria from the Mini International Neuropsychiatric Interview (MINI), we identified the prevalence of a major depressive episode at the time of the interview among respondents and analyzed its association with demographic, socioeconomic, and health characteristics through a multivariate analysis. Major depressive episode prevalence was 4.3 % (95 % CI: 3.1-5.5 %) among the survey respondents. We found a strong association between major depressive episode and reported chronic health problems, functional limitations, ethnicity and religion, household food shortages, having been recently a victim of physical violence and regularly drinking alcohol. Results show a U-shaped association of the relationship between major depressive episode and standard of living, with individuals in both the poorest and richest groups most likely to suffer from major depressive disorder than those in the middle. Though, the poorest group remains the most vulnerable one, even when controlling by health characteristics. Major depressive disorder is a reality for many urban residents in Burkina Faso and likely urbanites throughout sub-Saharan Africa. Countries in the region
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International Nuclear Information System (INIS)
Ren, Yuan; Qu, Zelong; Du, Yuanyuan; Xu, Ronghua; Ma, Danping; Yang, Guofu; Shi, Yan; Fan, Xing; Tani, Akira; Guo, Peipei; Ge, Ying; Chang, Jie
2017-01-01
Biogenic volatile organic compounds (BVOCs) emissions lead to fine particulate matter (PM 2.5 ) and ground-level ozone pollution, and are harmful to human health, especially in urban areas. However, most BVOCs estimations ignored the emissions from urban green spaces, causing inaccuracies in the understanding of regional BVOCs emissions and their environmental and health effects. In this study, we used the latest local vegetation datasets from our field survey and applied an estimation model to analyze the spatial-temporal patterns, air quality impacts, health damage and mitigating strategies of BVOCs emissions in the Greater Beijing Area. Results showed that: (1) the urban core was the hotspot of regional BVOCs emissions for the highest region-based emission intensity (3.0 g C m −2 yr −1 ) among the 11 sub-regions; (2) urban green spaces played much more important roles (account for 62% of total health damage) than rural forests in threating human health; (3) BVOCs emissions from green spaces will more than triple by 2050 due to urban area expansion, tree growth and environmental changes; and (4) adopting proactive management (e.g. adjusting tree species composition) can reduce 61% of the BVOCs emissions and 50% of the health damage related to BVOCs emissions by 2050. - Highlights: • Urban core is the hotspot of biogenic volatile organic compounds (BVOCs) emissions in the Greater Beijing Area. • Neglecting BVOCs emissions from urban green spaces leads to a 62% underestimation of the related health damage. • BVOCs contribute significantly to ozone pollution while make limited contribution to PM 2.5 pollution. • BVOCs emissions from urban green spaces will triple by 2050, and 61% of these emissions can be reduced through management. - Although BVOCs emissions from urban green spaces make limited contribution to regional emissions, their health impacts could be significant in urban areas.
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Erlyana, Erlyana; Damrongplasit, Kannika Kampanya; Melnick, Glenn
2011-05-01
This study investigates the importance of medical fee and distance to health care provider on individual's decision to seek care in developing countries. The estimation method used a mixed logit model applied to data from the third wave of the Indonesian family life survey (2000). The key variables of interest include medical fee and distance to different types of health care provider and individual characteristic variables. Urban dweller's decision to choose health care providers are sensitive to the monetary cost of medical care as measured by medical fee but they are not sensitive to distance. For those who reside in rural area, they are sensitive to the non-medical component cost of care as measured by travel distance but they are not sensitive to medical fee. As a result of those findings, policy makers should consider different sets of policy instruments when attempting to expand health service's usage in urban and rural areas of Indonesia. To increase access in urban areas, we recommend expansion of health insurance coverage in order to lower out-of-pocket medical expenditures. As for rural areas, expansion of medical infrastructures to reduce commuting distance and costs will be needed to increase utilization. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
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Bioaccessibility of metals and human health risk assessment in community urban gardens.
Izquierdo, M; De Miguel, E; Ortega, M F; Mingot, J
2015-09-01
Pseudo-total (i.e. aqua regia extractable) and gastric-bioaccessible (i.e. glycine+HCl extractable) concentrations of Ca, Co, Cr, Cu, Fe, Mn, Ni, Pb and Zn were determined in a total of 48 samples collected from six community urban gardens of different characteristics in the city of Madrid (Spain). Calcium carbonate appears to be the soil property that determines the bioaccessibility of a majority of those elements, and the lack of influence of organic matter, pH and texture can be explained by their low levels in the samples (organic matter) or their narrow range of variation (pH and texture). A conservative risk assessment with bioaccessible concentrations in two scenarios, i.e. adult urban farmers and children playing in urban gardens, revealed acceptable levels of risk, but with large differences between urban gardens depending on their history of land use and their proximity to busy areas in the city center. Only in a worst-case scenario in which children who use urban gardens as recreational areas also eat the produce grown in them would the risk exceed the limits of acceptability. Copyright © 2015 Elsevier Ltd. All rights reserved.
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78 FR 45543 - Center for Mental Health Services; Notice of Meeting
2013-07-29
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Substance Abuse and Mental Health Services Administration Center for Mental Health Services; Notice of Meeting Pursuant to Public Law 92-463, notice is hereby given that the Substance Abuse and Mental Health Services Administration's (SAMHSA) Center for Mental...
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Juvenile coho salmon growth and health in streams across an urbanization gradient
Spanjer, Andrew R.; Moran, Patrick W.; Larsen, Kimberly; Wetzel, Lisa; Hansen, Adam G.; Beauchamp, David A.
2018-01-01
Expanding human population and urbanization alters freshwater systems through structural changes to habitat, temperature effects from increased runoff and reduced canopy cover, altered flows, and increased toxicants. Current stream assessments stop short of measuring health or condition of species utilizing these freshwater habitats and fail to link specific stressors mechanistically to the health of organisms in the stream. Juvenile fish growth integrates both external and internal conditions providing a useful indicator of habitat quality and ecosystem health. Thus, there is a need to account for ecological and environmental influences on fish growth accurately. Bioenergetics models can simulate changes in growth and consumption in response to environmental conditions and food availability to account for interactions between an organism's environmental experience and utilization of available resources. The bioenergetics approach accounts for how thermal regime, food supply, and food quality affect fish growth. This study used a bioenergetics modeling approach to evaluate the environmental factors influencing juvenile coho salmon growth among ten Pacific Northwest streams spanning an urban gradient. Urban streams tended to be warmer, have earlier emergence dates and stronger early season growth. However, fish in urban streams experienced increased stress through lower growth efficiencies, especially later in the summer as temperatures warmed, with as much as a 16.6% reduction when compared to fish from other streams. Bioenergetics modeling successfully characterized salmonid growth in small perennial streams as part of a more extensive monitoring program and provides a powerful assessment tool for characterizing mixed life-stage specific responses in urban streams.
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Health status and air pollution related socioeconomic concerns in urban China
Jiao, Kaishan; Xu, Mengjia; Liu, Meng
2018-01-01
Background China is experiencing environmental issues and related health effects due to its industrialization and urbanization. The health effects associated with air pollution are not just a matter of epidemiology and environmental science research, but also an important social science issue. Literature about the relationship of socioeconomic factors with the environment and health factors is inadequate. The relationship between air pollution exposure and health effects in China was investig...
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Druss, Benjamin G.; Bornemann, Thomas; Fry-Johnson, Yvonne W.; McCombs, Harriet G.; Politzer, Robert M.; Rust, George
2006-01-01
Objective. We examined trends in delivery of mental health and substance abuse services at the nation’s community health centers. Methods. Analyses used data from the Health Resources and Services Administration (HRSA), Bureau of Primary Care’s (BPHC) 1998 and 2003 Uniform Data System, merged with county-level data. Results. Between 1998 and 2003, the number of patients diagnosed with a mental health/substance abuse disorder in community health centers increased from 210 000 to 800 000. There was an increase in the number of patients per specialty mental health/substance abuse treatment provider and a decline in the mean number of patient visits, from 7.3 visits per patient to 3.5 by 2003. Although most community health centers had some on-site mental health/substance abuse services, centers without on-site services were more likely to be located in counties with fewer mental health/substance abuse clinicians, psychiatric emergency rooms, and inpatient hospitals. Conclusions. Community health centers are playing an increasingly central role in providing mental health/substance abuse treatment services in the United States. It is critical both to ensure that these centers have adequate resources for providing mental health/substance abuse care and that they develop effective linkages with mental health/substance abuse clinicians in the communities they serve. PMID:17008573
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Cai, Jiaoli; Coyte, Peter C; Zhao, Hongzhong
2017-07-18
In recent decades, China has experienced tremendous economic growth and also witnessed growing socioeconomic-related health inequality. The study aims to explore the potential causes of socioeconomic-related health inequality in urban and rural areas of China over the past two decades. This study used six waves of the China Health and Nutrition Survey (CHNS) from 1991 to 2006. The recentered influence function (RIF) regression decomposition method was employed to decompose socioeconomic-related health inequality in China. Health status was derived from self-rated health (SRH) scores. The analyses were conducted on urban and rural samples separately. We found that the average level of health status declined from 1989 to 2006 for both urban and rural populations. Average health scores were greater for the rural population compared with those for the urban population. We also found that there exists pro-rich health inequality in China. While income and secondary education were the main factors to reduce health inequality, older people, unhealthy lifestyles and a poor home environment increased inequality. Health insurance had the opposite effects on health inequality for urban and rural populations, resulting in lower inequality for urban populations and higher inequality for their rural counterparts. These findings suggest that an effective way to reduce socioeconomic-related health inequality is not only to increase income and improve access to health care services, but also to focus on improvements in the lifestyles and the home environment. Specifically, for rural populations, it is particularly important to improve the design of health insurance and implement a more comprehensive insurance package that can effectively target the rural poor. Moreover, it is necessary to comprehensively promote the flush toilets and tap water in rural areas. For urban populations, in addition to promoting universal secondary education, healthy lifestyles should be promoted
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Koster, E M; de Gelder, R; Di Nardo, F; Williams, G; Harrison, A; van Buren, L P; Lyshol, H; Patterson, L; Birt, C A; Higgerson, J; Achterberg, P W; Verma, A; van Ameijden, E J C
2017-05-01
: In Europe, over 70% of the population live in urban areas (UAs). Most international comparative health research is done using national level data, as reliable and comparable urban data are often unavailable or difficult to access. This study aims to investigate whether population health is different in UAs compared with their corresponding countries. : Routinely available health-related data were collected by the EURO-URHIS 2 project, for 10 European countries and for 24 UAs within those countries. National and UA level data for 11 health indicators were compared through the calculation of relative difference, and geographical patterns within Europe were investigated using the Mann Whitney U test. Linear regression modelling was used to adjust for population density, gross domestic product and urbanicity. : In general, the urban population in Eastern Europe is less healthy than the Western European urban population. However, people in Eastern Europe have significantly better broad health outcomes in UAs as compared with the corresponding country as a whole, whereas people in Western Europe have generally worse broader health outcomes in UAs. : For most European countries and UAs that were investigated, the national level health status data does not correspond with the health status at UA level. In order to identify health problems in UAs and to provide information for local health policy, health monitoring and international benchmarking should also be conducted at the local level. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.
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2011-07-11
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Institute for Occupational Safety and Health, (NIOSH), World Trade Center Health Program Science/Technical Advisory Committee (WTCHP-STAC) Correction: This notice was published in the Federal Register on June 23...
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Urban Physics: Effect of the micro-climate on comfort, health and energy demand
Moonen, Peter; Defraeye, Thijs; Dorer, Viktor; Blocken, Bert; Carmeliet, Jan
2012-01-01
The global trend towards urbanisation explains the growing interest in the study of the modification of the urban climate due to the heat island effect and global warming, and its impact on energy use of buildings. Also urban comfort, health and durability, referring respectively to pedestrian wind/thermal comfort, pollutant dispersion and wind-driven rain are of interest. Urban Physics is a well-established discipline, incorporating relevant branches of physics, environmental chemistry, aero...
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Carter, Marion W; Gavin, Loretta; Zapata, Lauren B; Bornstein, Marta; Mautone-Smith, Nancy; Moskosky, Susan B
2016-10-01
This study aims to describe aspects of the scope and quality of family planning services provided by US publicly funded health centers before the release of relevant federal recommendations. Using nationally representative survey data (N=1615), we describe four aspects of service delivery: family planning services provided, contraceptive methods provided onsite, written contraceptive counseling protocols and youth-friendly services. We created a count index for each issue and used multivariable ordered logistic regression to identify health center characteristics associated with scoring higher on each. Half of the sample received Title X funding and about a third each were a community health center or health department clinic. The vast majority reported frequently providing contraceptive services (89%) and STD services (87%) for women in the past 3 months. Service provision to males was substantially lower except for STD screening. A total of 63% and 48% of health centers provided hormonal IUDs and implants onsite in the past 3 months, respectively. Forty percent of health centers included all five recommended contraceptive counseling practices in written protocols. Of youth-friendly services, active promotion of confidential services was among the most commonly reported (83%); offering weekend/evening hours was among the least (42%). In multivariable analyses, receiving Title X funding, having larger volumes of family planning clients and being a Planned Parenthood clinic were associated with higher scores on most indices. Many services were consistent with the recommendations for providing quality family planning services, but there was room for improvement across domains and health centers types. As assessed in this paper, the scope and quality of these family planning services was relatively high, particularly among Planned Parenthood clinics and Title X-funded centers. However, results point to important areas for improvement. Future studies should assess
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Sudhinaraset, May; Afulani, Patience; Diamond-Smith, Nadia; Bhattacharyya, Sanghita; Donnay, France; Montagu, Dominic
2017-11-06
Background: Globally, substantial health inequities exist with regard to maternal, newborn and reproductive health. Lack of access to good quality care-across its many dimensions-is a key factor driving these inequities. Significant global efforts have been made towards improving the quality of care within facilities for maternal and reproductive health. However, one critically overlooked aspect of quality improvement activities is person-centered care. Main body: The objective of this paper is to review existing literature and theories related to person-centered reproductive health care to develop a framework for improving the quality of reproductive health, particularly in low and middle-income countries. This paper proposes the Person-Centered Care Framework for Reproductive Health Equity, which describes three levels of interdependent contexts for women's reproductive health: societal and community determinants of health equity, women's health-seeking behaviors, and the quality of care within the walls of the facility. It lays out eight domains of person-centered care for maternal and reproductive health. Conclusions: Person-centered care has been shown to improve outcomes; yet, there is no consensus on definitions and measures in the area of women's reproductive health care. The proposed Framework reviews essential aspects of person-centered reproductive health care.
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Hartmann, William E.; Gone, Joseph P.
2013-01-01
Facing severe mental health disparities rooted in a complex history of cultural oppression, members of many urban American Indian (AI) communities are reaching out for indigenous traditional healing to augment their use of standard Western mental health services. Because detailed descriptions of approaches for making traditional healing available for urban AI communities do not exist in the literature, this community-based project convened 4 focus groups consisting of 26 members of a midwestern urban AI community to better understand traditional healing practices of interest and how they might be integrated into the mental health and substance abuse treatment services in an Urban Indian Health Organization (UIHO). Qualitative content analysis of focus group transcripts revealed that ceremonial participation, traditional education, culture keepers, and community cohesion were thought to be key components of a successful traditional healing program. Potential incorporation of these components into an urban environment, however, yielded 4 marked tensions: traditional healing protocols versus the realities of impoverished urban living, multitribal representation in traditional healing services versus relational consistency with the culture keepers who would provide them, enthusiasm for traditional healing versus uncertainty about who is trustworthy, and the integrity of traditional healing versus the appeal of alternative medicine. Although these tensions would likely arise in most urban AI clinical contexts, the way in which each is resolved will likely depend on tailored community needs, conditions, and mental health objectives. PMID:22731113
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The Breast Health Center at Women & Infants Hospital: origin, philosophy, and features.
Falkenberry, S S; Chung, M; Legare, R; Strenger, R; Wallace, D; Phillips, G; Morry, S; Marchant, D J; Cady, B
2000-04-01
The Breast Health Center, a component of the program in Women's Oncology at Women & Infants Hospital, is a multidisciplinary center devoted to the treatment and study of benign and malignant breast diseases. The philosophy, structure, and function of The Breast Health Center are described along with its specific components. The Breast Health Center's three fundamental missions of patient care, education, and research are discussed.
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Furtado, Kheya Melo; Kar, Anita
2014-04-01
There are limited primary data on the number of urban health care providers in private practice in developing countries like India. These data are needed to construct and test models that measure the efficacy of public stewardship of private sector health services. This study reports the number and characteristics of health resources in a 200 000 urban population in Pune. Data on health providers were collected by walking through the 15.46 sq km study area. Enumerated data were compared with existing data sources. Mapping was carried out using a Global Positioning System device. Metrics and characteristics of health resources were analyzed using ArcGIS 10.0 and Statistical Package for the Social Sciences, Version 16.0 software. Private sector health facilities constituted the majority (424/426, 99.5%) of health care services. Official data sources were only 39% complete. Doctor to population ratios were 2.8 and 0.03 per 1000 persons respectively in the private and public sector, and the nurse to doctor ratio was 0.24 and 0.71, respectively. There was an uneven distribution of private sector health services across the area (2-118 clinics per square kilometre). Bed strength was forty-fold higher in the private sector. Mandatory registration of private sector health services needs to be implemented which will provide an opportunity for public health planners to utilize these health resources to achieve urban health goals.
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Murphy, Kelly; Fafard, Patrick
2012-08-01
Knowledge translation (KT) is a growing movement in clinical and health services research, aimed to help make research more relevant and to move research into practice and policy. This paper examines the conventional model of policy change presented in KT and assesses its applicability for increasing the impact of urban health research on urban health policy. In general, KT conceptualizes research utilization in terms of the technical implementation of scientific findings, on the part of individual decision-makers who can be "targeted" for a KT intervention, in a context that is absent of political interests. However, complex urban health problems and interventions infrequently resemble this single decision, single decision-maker model posited by KT. In order to clarify the conditions under which urban health research is more likely or not to have an influence on public policy development, we propose to supplement the conventional model with three concepts drawn from the social science: policy stages, policy networks, and a discourse analysis approach for theorizing power in policy-making.
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Personal networks and locus of control in large urban centers of Argentina
Directory of Open Access Journals (Sweden)
Pablo De Grande
2013-12-01
Full Text Available This study analyzes the relationship between locus of control and interpersonal relations structures in Argentina. After a representative sample (n = 1500 of households in seven major urban centers (>200,000 inhabitants, it examines the relationship between the externality of locus of control and different aspects of personal networks of each respondent. The results show that people having more relations experiment lower levels of externality of locus of control. Likewise, lower levels of externality are informed when personal ties outside the neighborhood are available, as well as ties high educational level. In this regard, significant associations are verified between control and personal relations structures.
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The role of clinical toxicologists and poison control centers in public health.
Sutter, Mark E; Bronstein, Alvin C; Heard, Stuart E; Barthold, Claudia L; Lando, James; Lewis, Lauren S; Schier, Joshua G
2010-06-01
Poison control centers and clinical toxicologists serve many roles within public health; however, the degree to which these entities collaborate is unknown. The objective of this survey was to identify successful collaborations of public health agencies with clinical toxicologists and poison control centers. Four areas including outbreak identification, syndromic surveillance, terrorism preparedness, and daily public health responsibilities amenable to poison control center resources were assessed. An online survey was sent to the directors of poison control centers, state epidemiologists, and the most senior public health official in each state and selected major metropolitan areas. This survey focused on three areas: service, structure within the local or state public health system, and remuneration. Questions regarding remuneration and poison control center location within the public health structure were asked to assess if these were critical factors of successful collaborations. Senior state and local public health officials were excluded because of a low response rate. The survey was completed in October 2007. A total of 111 respondents, 61 poison control centers and 50 state epidemiologists, were eligible for the survey. Sixty-nine (62%) of the 111 respondents, completed and returned the survey. Thirty-three (54%) of the 61 poison control centers responded, and 36 of the 50 state epidemiologists (72%) responded. The most frequent collaborations were terrorism preparedness and epidemic illness reporting. Additional collaborations also exist. Important collaborations exist outside of remuneration or poison control centers being a formal part of the public health structure. Poison control centers have expanded their efforts to include outbreak identification, syndromic surveillance, terrorism preparedness, and daily public health responsibilities amenable to poison control center resources. Collaboration in these areas and others should be expanded. Published
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Sanitation health risk and safety planning in urban residential ...
African Journals Online (AJOL)
The aim of this review paper was to determine the best sanitation health risk and safety planning approach for sustainable management of urban environment. This was achieved by reviewing the concept of sanitation safety planning as a tool. The review adopted exploratory research approach and used secondary data ...
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Job satisfaction survey among health centers staff
Shahnazi, Hossein; Daniali, Seyede Shahrbanoo; Sharifirad, Gholamreza
2014-01-01
Background: Due to the importance of health care organizations with significant responsibility for prevention and care, assessment of job satisfaction among health care staff is essential. Quality of health services will be decreased provided they are not satisfied. Materials and Methods: This study was a cross-sectional analysis of health care staff in Khomeinishahr (centers, buildings, and networks) If they had at least 6 months work experience, they could enter the study. Data included a t...
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Rural Urban Disparity in and around Surabaya Region, Indonesia
Directory of Open Access Journals (Sweden)
Vely Kukinul Siswanto
2014-12-01
Full Text Available A shift in development towards the outskirts of urban areas changes the characteristics of the region and can ultimately lead to urban disparities in economic and social terms. The current study has tried to divide the study area covers the areas of surrounding Surabaya as urban, peri urban and rural areas with reference to three time periods (2008, 2009 and 2010 and shows that the typology in the study area changes each year. Furthermore, based on the theil index analysis, using a number of pre-prosperous household for social disparity and per capita GDP (Gross Domestic Product for economic disparity shows that urban and peri urban areas have medium and high level of social and economic disparity compare with rural area which have low levels of disparity. Through multivariate correlation analysis can be seen that the health center distance, electricity and water users effecting the social disparity. Moreover, the financial, industrial, electricity, trade, construction, transportation, agriculture, and mining sector's productivity have a significant relationship with the economic disparity. Health facilities, water and electricity improvement strategies to be followed for reducing the social disparity. Electricity improvement, water, services sector, transportation infrastructure, and industrial development to reduce the economic disparity.
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Committee opinion no. 515: Health care for urban American Indian and Alaska Native women.
2012-01-01
Sixty percent of American Indian and Alaska Native women live in metropolitan areas. Most are not eligible for health care provided by the federal Indian Health Service (IHS). The IHS partly funds 34 Urban Indian Health Organizations, which vary in size and services. Some are small informational and referral sites that are limited even in the scope of outpatient services provided. Compared with other urban populations, urban American Indian and Alaska Native women have higher rates of teenaged pregnancy, late or no prenatal care, and alcohol and tobacco use in pregnancy. Their infants have higher rates of preterm birth, mortality, and sudden infant death syndrome than infants in the general population. Barriers to care experienced by American Indian and Alaska Native women should be addressed. The American College of Obstetricians and Gynecologists encourages Fellows to be aware of the risk profile of their urban American Indian and Alaska Native patients and understand that they often are not eligible for IHS coverage and may need assistance in gaining access to other forms of coverage. The American College of Obstetricians and Gynecologists also recommends that Fellows encourage their federal legislators to support adequate funding for the Indian Health Care Improvement Act, permanently authorized as part of the Patient Protection and Affordable Care Act.
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Patterson, Steven L; Dancy, Blair C R; Ippolito, Danielle L; Stallings, Jonathan D
2017-11-01
: This paper presents environmental health risks which are prevalent in dense urban environments.We review the current literature and recommendations proposed by environmental medicine experts in a 2-day symposium sponsored by the Department of Defense and supported by the Johns Hopkins University Applied Physics Laboratory.Key hazards in the dense urban operational environment include toxic industrial chemicals and materials, water pollution and sewage, and air pollution. Four critical gaps in environmental medicine were identified: prioritizing chemical and environmental concerns, developing mobile decision aids, personalized health assessments, and better real-time health biomonitoring.As populations continue to concentrate in cities, civilian and military leaders will need to meet emerging environmental health concerns by developing and delivering adequate technology and policy solutions.
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Oladipo, Jimoh Ayanda
2014-06-01
Disparities in use of healthcare services between rural and urban areas have been empirically attributed to several factors. This study explores the existence of this disparity and its implication for planning and managing healthcare delivery systems. The objectives determine the relative importance of the various predisposing, enabling, need and health services factors on utilization of health services; similarity between rural and urban areas; and major explanatory variables for utilization. A four-stage model of service utilization was constructed with 31 variables under appropriate model components. Data is collected using cross-sectional sample survey of 1086 potential health services consumers in selected health facilities and resident milieu via questionnaire. Data is analyzed using factor analysis and cross tabulation. The 4-stage model is validated for the aggregate data and data for the rural areas with 3-stage model for urban areas. The order of importance of the factors is need, enabling, predisposing and health services. 11 variables are found to be powerful predictors of utilization. Planning of different categories of health care facilities in different locations should be based on utilization rates while proper management of established facilities should aim to improve health seeking behavior of people.
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A revisionist view of the integrated academic health center.
Rodin, Judith
2004-02-01
Like many academic health centers that had expanded aggressively during the 1990s, the nation's first vertically integrated academic health center, the University of Pennsylvania Health System, was profoundly challenged by the dramatic and unanticipated financial impacts of the Balanced Budget Act of 1997. The author explains why-although Penn's Health System had lost $300 million over two years and its debts threatened to cause serious financial and educational damage to the rest of the University-Penn chose to manage its way out of the financial crisis (instead of selling or spinning off its four hospitals, clinical practices, and possibly even its medical school). A strategy of comprehensive integration has not only stabilized Penn's Health System financially, but strengthened its position of leadership in medical education, research, and health care delivery. The author argues that a strategy of greater horizontal integration offers important strategic advantages to academic health centers. In an era when major social and scientific problems demand broadly multidisciplinary and highly-integrated approaches, such horizontally integrated institutions will be better able to educate citizens and train physicians, develop new approaches to health care policy, and answer pressing biomedical research questions. Institutional cultural integration is also crucial to create new, innovative organizational structures that bridge traditional disciplinary, school, and clinical boundaries.
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Reducing health risks from indoor exposures in rapidly developing urban China.
Zhang, Yinping; Mo, Jinhan; Weschler, Charles J
2013-07-01
Over the past two decades there has been a large migration of China's population from rural to urban regions. At the same time, residences in cities have changed in character from single-story or low-rise buildings to high-rise structures constructed and furnished with many synthetic materials. As a consequence, indoor exposures (to pollutants with outdoor and indoor sources) have changed significantly. We briefly discuss the inferred impact that urbanization and modernization have had on indoor exposures and public health in China. We argue that growing adverse health costs associated with these changes are not inevitable, and we present steps that could be taken to reduce indoor exposures to harmful pollutants. As documented by China's Ministry of Health, there have been significant increases in morbidity and mortality among urban residents over the past 20 years. Evidence suggests that the population's exposure to air pollutants has contributed to increases in lung cancer, cardiovascular disease, pulmonary disease, and birth defects. Whether a pollutant has an outdoor or an indoor source, most exposure to the pollutant occurs indoors. Going forward, indoor exposures can be reduced by limiting the ingress of outdoor pollutants (while providing adequate ventilation with clean air), minimizing indoor sources of pollutants, updating government policies related to indoor pollution, and addressing indoor air quality during a building's initial design. Taking the suggested steps could lead to significant reductions in morbidity and mortality, greatly reducing the societal costs associated with pollutant derived ill health.
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77 FR 50519 - Center for Mental Health Services (CMHS); Amendment of Meeting
2012-08-21
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Substance Abuse and Mental Health Services Administration Center for Mental Health Services (CMHS); Amendment of Meeting Pursuant to Public Law 92-463, notice is... Substance Abuse and Mental Health Services Administration's (SAMHSA), Center for Mental Health Services...
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2014-01-01
With the increasing trend in refugee urbanisation, growing numbers of refugees are diagnosed with chronic noncommunicable diseases (NCDs). However, with few exceptions, the local and international communities prioritise communicable diseases. The aim of this study is to review the literature to determine the prevalence and distribution of chronic NCDs among urban refugees living in developing countries, to report refugee access to health care for NCDs and to compare the prevalence of NCDs among urban refugees with the prevalence in their home countries. Major search engines and refugee agency websites were systematically searched between June and July 2012 for articles and reports on NCD prevalence among urban refugees. Most studies were conducted in the Middle East and indicated a high prevalence of NCDs among urban refugees in this region, but in general, the prevalence varied by refugees’ region or country of origin. Hypertension, musculoskeletal disease, diabetes and chronic respiratory disease were the major diseases observed. In general, most urban refugees in developing countries have adequate access to primary health care services. Further investigations are needed to document the burden of NCDs among urban refugees and to identify their need for health care in developing countries. PMID:24708876
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Wang, Jun; Liu, Ke; Zheng, Jing; Liu, Jiali; You, Liming
2017-11-14
Rural-to-urban migration, which has achieved a huge scale during China's economic reform, is a potential risk factor for the mental health of migrant children. To test this hypothesis, this study assessed the mental health status of rural-to-urban migrant children. Guided by Andersen's behavioral model, the study explored the risk factors associated with mental health. The study recruited 1182 fifth/sixth-grade children from four private and four public primary schools in Guangzhou in 2014 in a descriptive cross-sectional design. Mental health status was measured by the strengths and difficulties questionnaire. Predisposing characteristics including demographics (e.g., age, gender), social structure (e.g., education, occupation) and health beliefs (health attitude) were recorded. Enabling characteristics including family and community resources and the need for health services were analyzed to explore the risk factors. The results indicate that more rural-to-urban migrant children were classified in the abnormal (21.0%) or borderline (18.8%) categories based on the total difficulties scores, the proportions of which were much higher than those of local children (9.8% abnormal, 13.8% borderline). Factors associated with a greater likelihood of mental health problems included single-parent families, seeking health information actively, family income cannot meet basic needs and poor perceived health status. Compared with the local children, the rural-to-urban migrant children had relatively poor mental health, hence monitoring and supporting mental health for rural-urban migrant children is critical.
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75 FR 48853 - National Health Center Week, 2010
2010-08-11
... communities by conducting outreach and education, ensuring patients can communicate with their providers, and... information technology systems, and meet their critical care needs. The reforms in the landmark new health.... Community health centers are at the heart of a modern, reformed health care system in America. We must...
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Staeheli, Martha; Aseltine, Robert H; Schilling, Elizabeth; Anderson, Daren; Gould, Bruce
2017-01-01
Introduction: Behavioral health disorders remain under recognized and under diagnosed among urban primary care patients. Screening patients for such problems is widely recommended, yet is challenging to do in a brief primary care encounter, particularly for this socially and medically complex patient population. Methods: In 2013, intervention patients at an urban Connecticut primary clinic were screened for post-traumatic stress disorder, depression, and risky drinking (n?=?146) using an elec...
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Yu, Chen; Hui, Sun
2016-01-01
ABSTRACT With the acceleration of urbanization and industrialization, urban air pollution has become a serious threat to the health of urban residents. In this study, to investigate health hazards caused by air pollution for urban residents, concentrations of main air pollutants and annual coal consumption amounts during the period from 2000 to 2013 were analyzed. Our results showed that economic losses of Urumqi caused by air pollution amounted to 63.155 million yuan in 2013, accounting for ...
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Mehta, Nishant; Rajpurohit, Ladusingh; Ankola, Anil; Hebbal, Mamata; Setia, Priyanka
2015-05-01
To access knowledge and practices related to the oral health of geriatrics among the health care providers practicing in urban and rural areas. Older adults have identified a number of barriers that contribute to lack of dental service use. However, barriers that clinicians encounter in providing dental treatment to older adults are not as clear-cut. 236 health professionals (of allopathy, ayurveda, and homeopathy) from urban and rural areas were assessed by means of structured questionnaire related to oral health practices and beliefs. Doctors practicing in urban areas assessed dental care needs more frequently (P = 0.038) and performed greater practices related to oral health of geriatrics (P = 0.043) than the doctors practicing in primary health care (PHC) centers (rural) (P = 0.038). Owing to the relative lack of knowledge among rural practitioners, there is a need to integrate primary health care with oral care in rural areas.
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The organization of HIV and other health activities within urban religious congregations.
Palar, Kartika; Mendel, Peter; Derose, Kathryn Pitkin
2013-10-01
Most religious congregations in the USA are involved with some type of social service activity, including health activities. However, relatively few formally engage with people with HIV, and many have reported barriers to introducing HIV prevention activities. We conducted a qualitative case study of HIV involvement among 14 urban congregations in Los Angeles County in 2007. In-depth qualitative interviews of lay leaders and clergy were analyzed for themes related to HIV and other health activities, including types of health issues addressed, types of activities conducted, how activities were organized, and the relationship between HIV and other health activities. We identified three primary models representing how congregations organized HIV and other health activities: (1) embedded (n = 7), where HIV activities were contained within other health activities; (2) parallel (n = 5), where HIV and other health activities occurred side by side and were organizationally distinct; (3) overlap (n = 2), where HIV and non-HIV health efforts were conducted by distinct groups, but shared some members and organization. We discuss implications of each model for initiating and sustaining HIV activities within urban congregations over time.
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Opportunities and challenges within urban health and sustainable development
DEFF Research Database (Denmark)
Fisher, Jack E.; Andersen, Zorana J.; Loft, Steffen
2017-01-01
The United Nations’ Sustainable Development Goals mark aunique window of opportunity for both human and planetaryhealth. With rising life expectancy and rapidly expanding urbanpopulations exposed to pollution and sedentary lifestyles, thereis a greater focus on reducing the gap between life...... expectancyand number of healthy years lived, whilst limiting anthropogenicactivities contributing to pollution and climate change. Thus,urban development and policies, which can create win–winsituations for our planet and human health, falls into the realmand expertise of public health. However, some...
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Directory of Open Access Journals (Sweden)
Tsuno Yoko Sumikawa
2012-12-01
Full Text Available Abstract Background The salutogenic model states that coping resources are defined within sociocultural and historical contexts and that various social and historical factors influence the availability of such resources. Though previous studies have suggested the need for an interregional comparison of psychological and social resources, few studies have undertaken such an investigation. The aim of this study is to investigate the associations among coping resources, sense of coherence (SOC, and health status in a comparison of urban and rural residents. Methods General residents (aged 30–69 years in two areas were targeted for the current study. Through a random sampling selection, 1,000 residents from each area were picked, and an anonymous questionnaire was mailed to each resident. Ultimately, 269 and 363 valid responses from the urban and rural areas, respectively, were analyzed. SOC, both social and psychological resources, and mental health were assessed. To examine relationships between SOC and resources associated with mental health, mental health was defined as a dependent variable. Hierarchical multiple regression was conducted with variables entered from sociodemographic characteristics, social and psychological resources, and SOC. Results Regarding regional characteristics, social capital and participation in community activities were significantly greater in the rural area than in the urban area. Urban residents reported significantly higher self-esteem and optimism than rural residents. SOC showed the most significant association with mental health in both areas. Mental health was significantly associated with physical activity limitations and life stressors in both areas. However, the associations were weakened when social and psychological resources and SOC were added, which demonstrated their buffering effect on the negative influence of life stressors on health. When SOC was added, the association of self-esteem with mental
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Factors shaping effective utilization of health information technology in urban safety-net clinics.
George, Sheba; Garth, Belinda; Fish, Allison; Baker, Richard
2013-09-01
Urban safety-net clinics are considered prime targets for the adoption of health information technology innovations; however, little is known about their utilization in such safety-net settings. Current scholarship provides limited guidance on the implementation of health information technology into safety-net settings as it typically assumes that adopting institutions have sufficient basic resources. This study addresses this gap by exploring the unique challenges urban resource-poor safety-net clinics must consider when adopting and utilizing health information technology. In-depth interviews (N = 15) were used with key stakeholders (clinic chief executive officers, medical directors, nursing directors, chief financial officers, and information technology directors) from staff at four clinics to explore (a) nonhealth information technology-related clinic needs, (b) how health information technology may provide solutions, and (c) perceptions of and experiences with health information technology. Participants identified several challenges, some of which appear amenable to health information technology solutions. Also identified were requirements for effective utilization of health information technology including physical infrastructural improvements, funding for equipment/training, creation of user groups to share health information technology knowledge/experiences, and specially tailored electronic billing guidelines. We found that despite the potential benefit that can be derived from health information technologies, the unplanned and uninformed introduction of these tools into these settings might actually create more problems than are solved. From these data, we were able to identify a set of factors that should be considered when integrating health information technology into the existing workflows of low-resourced urban safety-net clinics in order to maximize their utilization and enhance the quality of health care in such settings.
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Directory of Open Access Journals (Sweden)
Lidan Wang
Full Text Available The paper examines whether out-of-pocket health care expenditure also has regional discrepancies, comparing to the equity between urban and rural areas, and across households.Sampled data were derived from Urban Household Survey and Rural Household Survey data for 2011/2012 for Anhui Province, and 11049 households were included in this study. The study compared differences in out-of-pocket expenditure on health care between regions (urban vs. rural areas and years (2011 vs. 2012 using two-sample t-test, and also investigated the degree of inequality using Lorenz and concentration curves.Approximately 5% and 8% of total household consumption expenditure was spent on health care for urban and rural populations, respectively. In 2012, the wealthiest 20% of urban and rural population contributed 49.7% and 55.8% of urban and rural total health expenditure respectively, while the poorest 20% took only 4.7% and 4.4%. The concentration curve for out-of-pocket expenditure in 2012 fell below the corresponding concentration curve for 2011 for both urban and rural areas, and the difference between curves for rural areas was greater than that for urban areas.A substantial and increasing gap in health care expenditures existed between urban and rural areas in Anhui. The health care financing inequality merits ample attention, with need for policymaking to focus on improving the accessibility to essential health care services, particularly for rural and poor residents. This study may provide useful information on low income areas of China.
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National Maternal and Child Oral Health Resource Center
... State Offices Search the Organizations Database Center for Oral Health Systems Integration and Improvement (COHSII) COHSII is a ... needs of the MCH population. Brush Up on Oral Health This monthly newsletter provides Head Start staff with ...
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Urbanism, ethnic consciousness and affinity in Nigeria | Ofili ...
African Journals Online (AJOL)
Nigeria, just like any other nation in the world, can boast of several urban centers or settlements. These urban centers emerged as a result of their historical role in the formation and development of the country. With urbanization, it is expected that an urban culture of individuality, transiency and anonymity arising from the ...
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Neighborhood disorder, peer network health, and substance use among young urban adolescents.
Mason, Michael J; Light, John M; Mennis, Jeremy; Rusby, Julie C; Westling, Erika; Crewe, Stephanie; Zaharakis, Nikola; Way, Thomas; Flay, Brian R
2017-09-01
The current study investigated the moderating effect of peer networks on neighborhood disorder's association with substance use in a sample of primarily African American urban adolescents. A convenience sample of 248 adolescents was recruited from urban health care settings and followed for two years, assessing psychological, social, and geographic risk and protective characteristics. A subset of 106 substance using participants were used for the analyses. A moderation model was tested to determine if the influence of neighborhood disorder (percent vacant housing, assault index, percent single parent headed households, percent home owner occupied, percent below poverty line) on substance use was moderated by peer network health (sum of peer risk and protective behaviors). Evidence for hypothesized peer network moderation was supported. A latent growth model found that peer network health is most strongly associated with lower baseline substance use for young adolescents residing in more disordered neighborhoods. Over the course of two years (ages approximately 14-16) this protective effect declines, and the decline is stronger for more disordered neighborhoods. Understanding the longitudinal moderating effects of peer networks within high-risk urban settings is important to the development and testing of contextually sensitive peer-based interventions. suggest that targeting the potential protective qualities of peer networks may be a promising approach for interventions seeking to reduce substance use, particularly among younger urban adolescents living in high-risk neighborhoods. Copyright © 2017 Elsevier B.V. All rights reserved.
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U.S. academic medical centers under the managed health care environment.
Guo, K
1999-06-01
This research investigates the impact of managed health care on academic medical centers in the United States. Academic medical centers hold a unique position in the U.S. health care system through their missions of conducting cutting-edge biomedical research, pursuing clinical and technological innovations, providing state-of-the-art medical care and producing highly qualified health professionals. However, policies to control costs through the use of managed care and limiting resources are detrimental to academic medical centers and impede the advancement of medical science. To survive the threats of managed care in the health care environment, academic medical centers must rely on their upper level managers to derive successful strategies. The methods used in this study include qualitative approaches in the form of key informants and case studies. In addition, a survey questionnaire was sent to 108 CEOs in all the academic medical centers in the U.S. The findings revealed that managers who perform the liaison, monitor, entrepreneur and resource allocator roles are crucial to ensure the survival of academic medical centers, so that academic medical centers can continue their missions to serve the general public and promote their well-being.
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Audit of a diabetic health education program at a large Primary Health Care Center in Asir region.
Al-Khaldi, Y M; Khan, M Y
2000-09-01
To evaluate the health education program in a large Primary Health Care Center, to find out the problems faced by the staff and to suggest the practical and relevant solutions. This study was carried out at Wasat Abha Primary Health Care Center, Asir region during 1997. The files of diabetics who attended the center were evaluated for health education topics by using a checklist. The essential structure of diabetic health education program was assessed by using another check list designed by the investigators. Data entry and analysis was carried out through SPSS package. Chi-square test was applied wherever necessary. The total number of diabetics who attended Wasat Abha Primary Health Care Center was 198. The duration of diabetes mellitus was 7.7+5.8 years. Ninety percent of these were married, 50.5% were educated and 79% were employed. Compliance to appointment was good in 60% and poor in 30% of diabetics. About 73% of the diabetics received at least one health education topic while 27% did not receive any health education at all. Only 33% of diabetic patients had adequate health education. Ninety one percent were provided with diabetic identification cards, 80% were explained about diabetes and 77% were educated about the role of diet. Essential structure for diabetes education program was found to be unsatisfactory. Effective diabetic health education program needs the availability of all essential structures, community participation and integration of the government and private sectors. The deficiencies in the structures and the process of health education programs in our practice are almost universal to other Primary Health Care Centers in the Asir region. Providing the Primary Health Care Centers with all essential structures and annual auditing are complimentary to a successful diabetic health education program.
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Mental health status and related characteristics of Chinese male rural-urban migrant workers.
Yang, Tingzhong; Xu, Xiaochao; Li, Mu; Rockett, Ian R H; Zhu, Waner; Ellison-Barnes, Alejandra
2012-06-01
To explore mental health status and related characteristics in a sample of Chinese male rural-urban migrants. Subjects were 1,595 male rural-urban migrant workers selected though a multi-stage sample survey conducted in two cities (Hangzhou and Guangzhou). Data were collected by means of a self-administered questionnaire. Both life and work stressors were examined. Stress and mental health status were measured by the Chinese Perceived Stress Scale (CPSS) and the Chinese Health Questionnaire (CHQ), respectively. Unconditional logistic regression analysis was performed to identify factors associated with probable mental disorders. There are approximately 120 million rural-urban migrants in China. The prevalence of probable mental disorders in the sample population was 24.4% (95% CI: 23.3-25.5%), which was higher than among urban residents (20.2%, 95% CI: 18.8-21.7%). Logistic regression analysis revealed that five characteristics were positively associated with risk for probable mental disorders: originating in the South (OR = 2.00; 95% CI = 1.02, 4.00), higher life stress (OR = 7.63; 95% CI = 5.88, 10.00), staying in the city for 5-9 months each year (OR = 2.56; 95% CI = 1.67, 3.85), higher work stress (OR = 2.56; 95% CI = 1.96, 3.33), and separation from wife (OR = 2.43; 95% CI = 1.61, 3.57). Employment in machinery and transportation (OR = 0.54; 95% CI = 0.36, 0.81) and higher self-worth (OR = 0.42; 95% CI = 0.28, 0.62) were negatively associated. Findings support an urgent need to develop specific policies and programs to address mental health problems among Chinese rural-urban migrants.
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Policy directions in urban health in developing countries--the slum improvement approach.
Harpham, T; Stephens, C
1992-07-01
The urban development, or housing, sector has a longer experience of addressing the problems of the urban poor in developing countries than the health sector. In recent years the policy of 'slum improvement', which involves both sectors, has attracted the support of international donors. This article documents the development of the slum improvement approach and addresses key issues of the approach which have implications for health planning: covering the poorest dwellers; relocation; land tenure; gentrification; debt burdens and the impact on women. Questions about the approach which still need answering are defined and a summary of the constraints in slum improvement and potential solutions is presented.
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Lebrun-Harris, Lydie A; Baggett, Travis P; Jenkins, Darlene M; Sripipatana, Alek; Sharma, Ravi; Hayashi, A Seiji; Daly, Charles A; Ngo-Metzger, Quyen
2013-01-01
Objective To examine health status and health care experiences of homeless patients in health centers and to compare them with their nonhomeless counterparts. Data Sources/Study Setting Nationally representative data from the 2009 Health Center Patient Survey. Study Design Cross-sectional analyses were limited to adults (n = 2,683). We compared sociodemographic characteristics, health conditions, access to health care, and utilization of services among homeless and nonhomeless patients. We also examined the independent effect of homelessness on health care access and utilization, as well as factors that influenced homeless patients' health care experiences. Data Collection Computer-assisted personal interviews were conducted with health center patients. Principal Findings Homeless patients had worse health status—lifetime burden of chronic conditions, mental health problems, and substance use problems—compared with housed respondents. In adjusted analyses, homeless patients had twice the odds as housed patients of having unmet medical care needs in the past year (OR = 1.98, 95 percent CI: 1.24–3.16) and twice the odds of having an ED visit in the past year (OR = 2.00, 95 percent CI: 1.37–2.92). Conclusions There is an ongoing need to focus on the health issues that disproportionately affect homeless populations. Among health center patients, homelessness is an independent risk factor for unmet medical needs and ED use. PMID:23134588
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Employee health benefit redesign at the academic health center: a case study.
Marshall, Julie; Weaver, Deirdre C; Splaine, Kevin; Hefner, David S; Kirch, Darrell G; Paz, Harold L
2013-03-01
The rapidly escalating cost of health care, including the cost of providing health care benefits, is a significant concern for many employers. In this article, the authors examine a case study of an academic health center that undertook a complete redesign of its health benefit structure to control rising costs, encourage use of its own provider network, and support employee wellness. With the implementation in 2006 of a high-deductible health plan combined with health reimbursement arrangements and wellness incentives, the Penn State Hershey Medical Center (PSHMC) was able to realize significant cost savings and increase use of its own network while maintaining a high level of employee satisfaction. By contracting with a single third-party administrator for its self-insured plan, PSHMC reduced its administrative costs and simplified benefit choices for employees. In addition, indexing employee costs to salary ensured that this change was equitable for all employees, and the shift to a consumer-driven health plan led to greater employee awareness of health care costs. The new health benefit plan's strong focus on employee wellness and preventive health has led to significant increases in the use of preventive health services, including health risk assessments, cancer screenings, and flu shots. PSHMC's experience demonstrates the importance of clear and ongoing communication with employees throughout--before, during, and even after--the process of health benefit redesign.
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Wineman, Nicole V; Braun, Barbara I; Barbera, Joseph A; Loeb, Jerod M
2007-11-01
To assess the state of health center integration into community preparedness, we undertook a national study of linkages between health centers and the emergency preparedness and response planning initiatives in their communities. The key objectives of this project were to gain a better understanding of existing linkages in a nationally representative sample of health centers, and identify health center demographic and experience factors that were associated with strong linkages. The objectives of the study were to gain a baseline understanding of existing health center linkages to community emergency preparedness and response systems and to identify factors that were associated with strong linkages. A 60-item questionnaire was mailed to the population of health centers supported by the Health Resources and Services Administration's Bureau of Primary Health Care in February 2005. Results were aggregated and a chi square analysis identified factors associated with stronger linkages. Overall performance on study-defined indicators of strong linkages was low: 34% had completed a hazard vulnerability analysis in collaboration with the community emergency management agency, 30% had their role documented in the community plan, and 24% participated in community-wide exercises. Stronger linkages were associated with experience responding to a disaster and a perception of high risk for experiencing a disaster. The potential for health centers to participate in an integrated response is not fully realized, and their absence from community-based planning leaves an already vulnerable population at greater risk. Community planners should be encouraged to include health centers in planning and response and centers should receive more targeted resources for community integration.
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Weight- and race-based bullying: Health associations among urban adolescents
Rosenthal, Lisa; Earnshaw, Valerie A; Carroll-Scott, Amy; Henderson, Kathryn E; Peters, Susan M; McCaslin, Catherine; Ickovics, Jeannette R
2013-01-01
Stigma-based bullying is associated with negative mental and physical health outcomes. In a longitudinal study, surveys and physical assessments were conducted with mostly Black and Latino, socioeconomically disadvantaged, urban students. As hypothesized, greater weight- and race-based bullying each was significantly indirectly associated with increased blood pressure and body mass index, as well as decreased overall self-rated health across 2 years, through the mechanism of more negative emo...
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Viniece Jennings; Lincoln Larson; Jessica Yun
2016-01-01
Urban green spaces provide an array of benefits, or ecosystem services, that support our physical, psychological, and social health. In many cases, however, these benefits are not equitably distributed across diverse urban populations. In this paper, we explore relationships between cultural ecosystem services provided by urban green space and the social determinants...
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Slum Definitions in Urban India: Implications for the Measurement of Health Inequalities
Nolan, Laura B.
2015-01-01
Half the population of low- and middle-income countries will live in urban areas by 2030, and poverty and inequality in these contexts is rising. Slum dwelling is one way in which to conceptualize and characterize urban deprivation but there are many definitions of what constitutes a slum. This paper presents four different slum definitions used in India alone, demonstrating that assessments of both the distribution and extent of urban deprivation depends on the way in which it is characterized, as does slum dwelling’s association with common child health indicators. Using data from India’s National Family and Health Survey from 2005–2006, two indictors of slum dwelling embedded in the survey and two constructed from the household questionnaire are compared using descriptive statistics and linear regression models of height- and weight-for-age z-scores. The results highlight a tension between international and local slum definitions, and underscore the importance of improving empirical representations of the dynamism of slum and city residents. PMID:26877568
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Homelessness and Health â Part II
Centers for Disease Control (CDC) Podcasts
2010-11-19
Homelessness in the 21st century is an ongoing problem, increasing due to the country's recent economic downturn, especially in urban areas. This podcast discusses how homelessness impacts health and what public health professionals can do about it. Created: 11/19/2010 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) and National Center for Environmental Health (NCEH). Date Released: 11/19/2010.
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Homelessness and Health â Part I
Centers for Disease Control (CDC) Podcasts
2010-11-19
Homelessness in the 21st century is an ongoing problem, increasing due to the country's recent economic downturn, especially in urban areas. This podcast discusses how homelessness impacts health and what public health professionals can do about it. Created: 11/19/2010 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) and National Center for Environmental Health (NCEH). Date Released: 11/19/2010.
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Urban green spaces assessment approach to health, safety and environment
Directory of Open Access Journals (Sweden)
B. Akbari Neisiani
2016-04-01
Full Text Available The city is alive with dynamic systems, where parks and urban green spaces have high strategic importance which help to improve living conditions. Urban parks are used as visual landscape with so many benefits such as reducing stress, reducing air pollution and producing oxygen, creating opportunities for people to participate in physical activities, optimal environment for children and decreasing noise pollution. The importance of parks is such extent that are discussed as an indicator of urban development. Hereupon the design and maintenance of urban green spaces requires integrated management system based on international standards of health, safety and the environment. In this study, Nezami Ganjavi Park (District 6 of Tehran with the approach to integrated management systems have been analyzed. In order to identify the status of the park in terms of the requirements of the management system based on previous studies and all Tehran Municipality’s considerations, a check list has been prepared and completed by park survey and interview with green space experts. The results showed that the utility of health indicators were 92.33 % (the highest and environmental and safety indicators were 72 %, 84 % respectively. According to SWOT analysis in Nezami Ganjavi Park some of strength points are fire extinguishers, first aid box, annual testing of drinking water and important weakness is using unseparated trash bins also as an opportunities, there are some interesting factors for children and parents to spend free times. Finally, the most important threat is unsuitable park facilities for disabled.
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Social determinants of childhood asthma symptoms: an ecological study in urban Latin America.
Fattore, Gisel L; Santos, Carlos A T; Barreto, Mauricio L
2014-04-01
Asthma is an important public health problem in urban Latin America. This study aimed to analyze the role of socioeconomic and environmental factors as potential determinants of asthma symptoms prevalence in children from Latin American (LA) urban centers. We selected 31 LA urban centers with complete data, and an ecological analysis was performed. According to our theoretical framework, the explanatory variables were classified in three levels: distal, intermediate, and proximate. The association between variables in the three levels and prevalence of asthma symptoms was examined by bivariate and multivariate linear regression analysis weighed by sample size. In a second stage, we fitted several linear regression models introducing sequentially the variables according to the predefined hierarchy. In the final hierarchical model Gini Index, crowding, sanitation, variation in infant mortality rates and homicide rates, explained great part of the variance in asthma prevalence between centers (R(2) = 75.0 %). We found a strong association between socioeconomic and environmental variables and prevalence of asthma symptoms in LA urban children, and according to our hierarchical framework and the results found we suggest that social inequalities (measured by the Gini Index) is a central determinant to explain high prevalence of asthma in LA.
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The urban district of Nancy and the Town of Nancy, France, have taken the initiative of creating an International Center of Water (Centre International de l'Eau à Nancy—NAN.C.I.E.) in association with two universities, six engineering colleges, the Research Centers of Nancy, the Rhine-Meuse Basin Agency, and the Chamber of Commerce and Industry. The aim of this center is to promote research and technology transfer in the areas of water and sanitation. In 1985 it will initiate a research program drawing on the experience of 350 researchers and engineers of various disciplines who have already been assigned to research in these fields. The research themes, the majority of which will be multidisciplinary, concern aspects of hygiene and health, the engineering of industrial processes, water resources, and the environment and agriculture. A specialist training program offering five types of training aimed at university graduates, graduates of engineering colleges, or experts, will start in October 1984.
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Globalisation and climate change in Asia: the urban health impact.
Munslow, Barry; O'Dempsey, Tim
2010-01-01
Asia's economic development successes will create new policy areas to address, as the advances made through globalisation create greater climate change challenges, particularly the impact on urban health. Poverty eradication and higher standards of living both increase demand on resources. Globalisation increases inequalities and those who are currently the losers will carry the greatest burden of the costs in the form of the negative effects of climate change and the humanitarian crises that will ensue. Of four major climate change challenges affecting the environment and health, two—urban air pollution and waste management—can be mitigated by policy change and technological innovation if sufficient resources are allocated. Because of the urban bias in the development process, these challenges will probably register on policy makers' agenda. The second two major challenges—floods and drought—are less amenable to policy and technological solutions: many humanitarian emergency challenges lie ahead. This article describes the widely varying impact of both globalisation and climate change across Asia. The greatest losers are those who flee one marginal location, the arid inland areas, only to settle in another marginal location in the flood prone coastal slums. Effective preparation is required, and an effective response when subsequent humanitarian crises occur.
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Violence against health workers in Family Medicine Centers.
Al-Turki, Nouf; Afify, Ayman Am; AlAteeq, Mohammed
2016-01-01
Health care violence is a significant worldwide problem with negative consequences on both the safety and well-being of health care workers as well as workplace activities. Reports examining health care violence in Saudi Arabia are limited and the results are conflicting. To estimate the prevalence and determine the demographic and occupational characteristics associated with workplace violence in primary care centers in Riyadh, Saudi Arabia. A cross-sectional study included 270 health care workers in 12 family medicine centers in Riyadh during November and December 2014. A structured self-administered questionnaire was used to estimate the frequency, timing, causes, reactions, and consequences of workplace violence plus participants' demographic and occupational data. A total 123 health care workers (45.6%) experienced some kind of violence over 12 months prior to the study. These included physical (6.5%) and nonphysical violence (99.2%), including verbal violence (94.3%) and intimidation (22.0%). Offenders were patients (71.5%) in the majority of cases, companions (20.3%), or both (3.3%). Almost half (48.0%) of health care workers who experienced violence did nothing, 38.2% actively reported the event, and 13.8% consulted a colleague. A significant association of workplace violence was found with working multiple shifts, evening or night shift, and lack of an encouraging environment to report violence. Workplace violence is still a significant problem in primary care centers. The high frequency of violence together with underreporting may indicate the inefficiency of the current safety program. More safety programs and training activities for health care workers, efficient reporting system, and zero tolerance policies need to be implemented to minimize workplace violence against health workers.
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Urban-rural variations in health in the Netherlands: does selective migration play a part?
Verheij, R.A.; Mheen, H.D. van de; Bakker, D.H. de; Groenewegen, P.P.; Mackenbach, J.P.
1998-01-01
Study objective: urban-rural health differences are observed in many countries, even when socioeconomic and demographic characteristics are controlled for. People living in urban areas are often found to be less healthy. One of the possible causes for these differences is selective migration with
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Khawaja, Marwan; Mowafi, Mona
2006-05-01
This paper examines the association between cultural capital and self-rated psychosocial health among poor, ever-married Lebanese women living in an urban context. Both self-rated general and mental health status were assessed using data from a cross-sectional survey of 1,869 women conducted in 2003. Associations between self-rated general and mental health status and cultural capital were obtained using chi (2) tests and odds ratios from binary logistic regression models. Cultural capital had significant associations with self-perceived general and mental health status net of the effects of social capital, SES, demographics, community and health risk factors. For example, the odds ratios for poor general and mental health associated with low cultural capital were 4.5 (CI: 2.95-6.95) and 2.9 (CI: 2.09-4.05), respectively, as compared to participants with high cultural capital. As expected, health risk factors were significantly associated with both measures of health status. However, demographic and community variables were associated with general health but not with mental health status. The findings pertaining to social capital and measures of SES were mixed. Cultural capital was a powerful and significant predictor of self-perceived general and mental health among women living in poor urban communities.
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Directory of Open Access Journals (Sweden)
Asma Perveen
2017-09-01
Full Text Available Objective: The purpose of this study was to explore the prevalence of psychological disorders among community health centers in Batang Padang district Perak. Material & Methods: To conduct this study survey research method was used, seven community health centers in Batang Padang District, Perak were contacted to collect data from (N=216 respondents, who attended health facilities in Batang Padang District. There is no age limit, no education difference and no other requirement needed. Instrument and Materials: Depression, Anxiety and Stress Scale (DASS-21 PRIME Screen and PRIME MD Patient Health Questionnaire (PHQ. Results: Data collected from seven health community centers revealed that prevalence of Stress 86%, anxiety 124%, depression 67, psychotic symptoms 16%, somatoform symptoms 52%, panic symptoms 28%, and substance abuse 21%. the higher prevalence was stress and depression among people attending health centers. Conclusion: Results findings indicated that there is significant prevalence of psychological disorder among community health centers. Analysis of the results help us to determine that there is strong need to provide psychological services, awareness and education plan, management and prevention for psychological disorders
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Indigenous Māori perspectives on urban transport patterns linked to health and wellbeing.
Raerino Ngāti Awa Te Arawa, K; Macmillan, Alex K; Jones Ngāti Kahungunu, Rhys G
2013-09-01
There is a growing body of research linking urban transport systems to inequities in health. However, there is a lack of research providing evidence of the effect of transport systems on indigenous family wellbeing. We examined the connections between urban transport and the health and wellbeing of Māori, the indigenous people of New Zealand. We provide an indigenous exploration of current urban transport systems, with a particular focus on the impacts of car dependence and the need for culturally relevant travel. We interviewed nineteen Māori participants utilising qualitative research techniques underpinned by an indigenous research methodology (Kaupapa Māori). The data highlighted the importance of accessing cultural activities and sites relevant to 'being Māori', and issues with affordability and safety of public transport. Understanding the relationship between indigenous wellbeing and transport systems that goes further than limited discourses of inequity is essential to improving transport for indigenous wellbeing. Providing an indigenous voice in transport decision-making will make it more likely that indigenous health and wellbeing is prioritised in transport planning. Copyright © 2013. Published by Elsevier Ltd.
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Green Space Attachment and Health : A Comparative Study in Two Urban Neighborhoods
Zhang, Yang; van Dijk, Theodorus; Tang, Jianjun; van den Berg, Agnes
2015-01-01
The positive relationships between urban green space and health have been well documented. Little is known, however, about the role of residents’ emotional attachment to local green spaces in these relationships, and how attachment to green spaces and health may be promoted by the availability of
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Adongo, Philip Baba; Phillips, James F; Aikins, Moses; Arhin, Doris Afua; Schmitt, Margaret; Nwameme, Adanna U; Tabong, Philip Teg-Nefaah; Binka, Fred N
2014-04-01
Rapid urban population growth is of global concern as it is accompanied with several new health challenges. The urban poor who reside in informal settlements are more vulnerable to these health challenges. Lack of formal government public health facilities for the provision of health care is also a common phenomenon among communities inhabited by the urban poor. To help ameliorate this situation, an innovative urban primary health system was introduced in urban Ghana, based on the milestones model developed with the rural Community-Based Health Planning and Services (CHPS) system. This paper provides an overview of innovative experiences adapted while addressing these urban health issues, including the process of deriving constructive lessons needed to inform discourse on the design and implementation of the sustainable Community-Based Health Planning and Services (CHPS) model as a response to urban health challenges in Southern Ghana. This research was conducted during the six-month pilot of the urban CHPS programme in two selected areas acting as the intervention and control arms of the design. Daily routine data were collected based on milestones initially delineated for the rural CHPS model in the control communities whilst in the intervention communities, some modifications were made to the rural milestones. The findings from the implementation activities revealed that many of the best practices derived from the rural CHPS experiment could not be transplanted to poor urban settlements due to the unique organizational structures and epidemiological characteristics found in the urban context. For example, constructing Community Health Compounds and residential facilities within zones, a central component to the rural CHPS strategy, proved inappropriate for the urban sector. Night and weekend home visit schedules were initiated to better accommodate urban residents and increase coverage. The breadth of the disease burden of the urban residents also requires a
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Akbarinejad, Farideh; Soleymani, Mohammad Reza; Shahrzadi, Leila
2017-01-01
The ability to access, analyze, evaluate, and convey information in various forms of media including print and nonprint requires media literacy, but the capacity to obtain, process, and understand basic information and services needed for appropriate decisions regarding health, considered an important element in a woman's ability to participate in health promotion and prevention activities for herself and her children, is needed to a level of health literacy. The purpose of this study was to determine the relationship between media literacy and health literacy among pregnant women in health centers in Isfahan. This study used a descriptive correlation study. Data collection tools include Shahin media literacy and functional health literacy in adults' questionnaires. The population include pregnant women in health centers of Isfahan (4080 people). Ten out of the 351 health centers in Isfahan were selected as cluster. Data were analyzed using both descriptive and inferential statistics. Media literacy of respondents in the five dimensions was significantly lower than average 61.5% of pregnant women have inadequate health literacy, 18.8% had marginal health literacy, and only 19.7% of them have had adequate health literacy. There was a significant positive relationship between media literacy and health literacy among pregnant women. This study showed that the majority of pregnant women covered by health centers had limited health literacy and media literacy. Since one of the basic requirements for the utilization of health information is needed for adequate media literacy, promotion of media literacy is necessary for the respondents.
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Health at the center of health systems reform: how philosophy can inform policy.
Sturmberg, Joachim P; Martin, Carmel M; Moes, Mark M
2010-01-01
Contemporary views hold that health and disease can be defined as objective states and thus should determine the design and delivery of health services. Yet health concepts are elusive and contestable. Health is neither an individual construction, a reflection of societal expectations, nor only the absence of pathologies. Based on philosophical and sociological theory, empirical evidence, and clinical experience, we argue that health has simultaneously objective and subjective features that converge into a dynamic complex-adaptive health model. Health (or its dysfunction, illness) is a dynamic state representing complex patterns of adaptation to body, mind, social, and environmental challenges, resulting in bodily homeostasis and personal internal coherence. The "balance of health" model-emergent, self-organizing, dynamic, and adaptive-underpins the very essence of medicine. This model should be the foundation for health systems design and also should inform therapeutic approaches, policy decision-making, and the development of emerging health service models. A complex adaptive health system focused on achieving the best possible "personal" health outcomes must provide the broad policy frameworks and resources required to implement people-centered health care. People-centered health systems are emergent in nature, resulting in locally different but mutually compatible solutions across the whole health system.
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Nieuwenhuijsen, Mark J; Khreis, Haneen; Verlinghieri, Ersilia; Mueller, Natalie; Rojas-Rueda, David
2017-06-01
Urban and transport planning have large impacts on public health, but these are generally not explicitly considered and/or quantified, partly because there are no comprehensive models, methods and tools readily available. Air pollution, noise, temperature, green space, motor vehicle crashes and physical activity are important pathways linking urban and transport planning and public health. For policy decision-making, it is important to understand and be able to quantify the full-chain from source through pathways to health effects and impacts to substantiate and effectively target actions. In this paper, we aim to provide an overview of recent studies on the health impacts related to urban and transport planning in cities, describe the need for novel participatory quantitative health impact assessments (HIA) and provide recommendations. To devise our searches and narrative, we were guided by a recent conceptual framework linking urban and transport planning, environmental exposures, behaviour and health. We searched PubMed, Web of Science, Science Direct, and references from relevant articles in English language from January 1, 1980, to November 1, 2016, using pre-defined search terms. The number of HIA studies is increasing rapidly, but there is lack of participatory integrated and full-chain HIA models, methods and tools. These should be based on the use of a systemic multidisciplinary/multisectorial approach and state-of-the-art methods to address questions such as what are the best, most feasible and needed urban and transport planning policy measures to improve public health in cities? Active citizen support and new forms of communication between experts and citizens and the involvement of all major stakeholders are crucial to find and successfully implement health promoting policy measures. We provided an overview of the current state-of-the art of HIA in cities and made recommendations for further work. The process on how to get there is as important and
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Achieving excellence in community health centers: implications for health reform.
Gurewich, Deborah; Capitman, John; Sirkin, Jenna; Traje, Diana
2012-02-01
Existing studies tell us little about care quality variation within the community health center (CHC) delivery system. They also tell us little about the organizational conditions associated with CHCs that deliver especially high quality care. The purpose of this study was to examine the operational practices associated with a sample of high performing CHCs. Qualitative case studies of eight CHCs identified as delivering high-quality care relative to other CHCs were used to examine operational practices, including systems to facilitate care access, manage patient care, and monitor performance. Four common themes emerged that may contribute to high performance. At the same time, important differences across health centers were observed, reflecting differences in local environments and CHC capacity. In the development of effective, community-based models of care, adapting care standards to meet the needs of local conditions may be important.
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Dilger, Hansjörg
2014-01-01
Over the past decades, new religious actors have become involved in the provision of medical care in urban Tanzania. Muslim revivalist organizations and neo-Pentecostal churches in particular have established a range of health interventions that are tied to revisionist claims about religion, spirituality, and politics in society. In this article I discuss medical mission in Dar es Salaam in the light of (post)colonial histories of health service provision as well as with regard to inter- and intradenominational contestations over health and well-being, a morally acceptable life, and political participation. I argue that the nature of the inscription of revivalist organizations in urban space through health interventions depends on their structural location and their respective members' social and economic capital. I also show that the ongoing transformations of urban space through medical mission have become reflective of, as well as are triggering, moral interpretations of history and social inequality in contemporary Tanzania.
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Comparing Performance of Public and Cooperative Health Centers
Directory of Open Access Journals (Sweden)
Mostafa Farahbakhsh
2012-04-01
Full Text Available Background: Health cooperatives in similar structure of health network in Iran, give primary health cares to defined population with supervisory of public sector. Materials and method: This study compares health system performance between public (PHC and cooperative (CHC health centers. Results: Client's satisfaction was 4.14 in CHC and 3.9 in PHC in 5 point Likert scale. The mean for daily health services of CHC and PHC were 110.8 and 85 respectively. Conclusion: Health cooperatives are appropriate strategy for downsizing of government in health sector
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Population pressure and health risks in urban market environment: a ...
African Journals Online (AJOL)
Population pressure and health risks in urban market environment: a study of Bodija market, Ibadan, Nigeria. ... International Journal of Development and Management Review ... This study was directed at permanent sellers in Bodija Market, (men and women) and people who frequent the market to make purchases.
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Directory of Open Access Journals (Sweden)
Bradley N Gaynes
Full Text Available Recent blue-ribbon panel reports have concluded that HIV treatment programs in less wealthy countries must integrate mental health identification and treatment into normal HIV clinical care and that research on mental health and HIV in these settings should be a high priority. We assessed the epidemiology of depression in HIV patients on antiretroviral therapy in a small urban setting in Cameroon by administering a structured interview for depression to 400 patients consecutively attending the Bamenda Regional Hospital AIDS Treatment Center. One in five participants met lifetime criteria for MDD, and 7% had MDD within the prior year. Only 33% had ever spoken with a health professional about depression, and 12% reported ever having received depression treatment that was helpful or effective. Over 2/3 with past-year MDD had severe or very severe episodes. The number of prior depressive episodes and the number of HIV symptoms were the strongest predictors of past-year MDD. The prevalence of MDD in Cameroon is as high as that of other HIV-associated conditions, such as tuberculosis and Hepatitis B virus, whose care is incorporated into World Health Organization guidelines. The management of depression needs to be incorporated in HIV-care guidelines in Cameroon and other similar settings.
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Directory of Open Access Journals (Sweden)
Mareike Kroll
2014-09-01
Full Text Available Background: Rapid urbanization in low- and middle-income countries reinforces risk and epidemiological transition in urban societies, which are characterized by high socioeconomic gradients. Limited availability of disaggregated morbidity data in these settings impedes research on epidemiological profiles of different population subgroups. Objective: The study aimed to analyze the epidemiological transition in the emerging megacity of Pune with respect to changing morbidity and mortality patterns, also taking into consideration health disparities among different socioeconomic groups. Design: A mixed-methods approach was used, comprising secondary analysis of mortality data, a survey among 900 households in six neighborhoods with different socioeconomic profiles, 46 in-depth interviews with laypeople, and expert interviews with 37 health care providers and 22 other health care workers. Results: The mortality data account for an epidemiological transition with an increasing number of deaths due to non-communicable diseases (NCDs in Pune. The share of deaths due to infectious and parasitic diseases remained nearly constant, though the cause of deaths changed considerably within this group. The survey data and expert interviews indicated a slightly higher prevalence of diabetes and hypertension among higher socioeconomic groups, but a higher incidence and more frequent complications and comorbidities in lower socioeconomic groups. Although the self-reported morbidity for malaria, gastroenteritis, and tuberculosis did not show a socioeconomic pattern, experts estimated the prevalence in lower socioeconomic groups to be higher, though all groups in Pune would be affected. Conclusions: The rising burden of NCDs among all socioeconomic groups and the concurrent persistence of communicable diseases pose a major challenge for public health. Improvement of urban health requires a stronger focus on health promotion and disease prevention for all
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Setting Goals for Urban Scale Climate Governance
Rosenthal, J. K.; Brunner, E.
2007-12-01
The impacts of climate change on temperate urban areas may include the increase in frequency and intensity of damaging extreme weather events, such as heat waves, hurricanes, heavy rainfall or drought, and coastal flooding and erosion, and potential adverse impacts on infrastructure, energy systems, and public health. Warmer average summertime temperatures are also associated with environmental and public health liabilities, such as decreased air quality and increased peak electrical demand. Simultaneously, a strong global trend towards urbanization of poverty exists, with increased challenges for local governments to protect and sustain the well-being of growing cities and populations currently stressed by poverty, health and economic inequities. In the context of these trends, research at the city scale has sought to understand the social and economic impacts of climate change and variability and to evaluate strategies in the built environment that might serve as adaptive and mitigative responses to climate change. We review the goals and outcomes of several municipal climate protection programs, generally categorized as approaches based on technological innovation (e.g., new materials); changes in behavior and public education (e.g., neighborhood watch programs and cooling centers); improvements in urban design (e.g., zoning for mixed land-use; the use of water, vegetation and plazas to reduce the urban heat island effect); and efforts to incentivize the use of non-fossil-fuel based energy sources. Urban initiatives in European and American cities are assessed within the context of the global collective efforts enacted by the Kyoto Protocol and United Nations Framework Convention on Climate Change. Our concern is to understand the active networked role of urban managers in climate policies and programs in relation to supranational objectives and non-state actors.
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Adams, Scott J; Xu, Stanley; Dong, Fran; Fortney, John; Rost, Kathryn
2006-01-01
Federally qualified health centers across the country are adopting depression disease management programs following federally mandated training; however, little is known about the relative effectiveness of depression disease management in rural versus urban patient populations. To explore whether a depression disease management program has a comparable impact on clinical outcomes over 2 years in patients treated in rural and urban primary care practices and whether the impact is mediated by receiving evidence-based care (antidepressant medication and specialty care counseling). A preplanned secondary analysis was conducted in a consecutively sampled cohort of 479 depressed primary care patients recruited from 12 practices in 10 states across the country participating in the Quality Enhancement for Strategic Teaming study. Depression disease management improved the mental health status of urban patients over 18 months but not rural patients. Effects were not mediated by antidepressant medication or specialty care counseling in urban or rural patients. Depression disease management appears to improve clinical outcomes in urban but not rural patients. Because these programs compete for scarce resources, health care organizations interested in delivering depression disease management to rural populations need to advocate for programs whose clinical effectiveness has been demonstrated for rural residents.
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Kotelchuck, Ronda; Lowenstein, Daniel; Tobin, Jonathan N
2011-11-01
Community health centers and community development financial institutions share similar origins and missions and are increasingly working together to meet community needs. Addressing the social and economic determinants of health is a common focus. The availability of new federal grants and tax credits has led these financial institutions to invest in the creation and expansion of community health centers. This article reviews the most recent trends in these two sectors and explores opportunities for further collaboration to transform the health and well-being of the nation's low-income communities.
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Violence against health workers in Family Medicine Centers
Directory of Open Access Journals (Sweden)
Al-Turki N
2016-05-01
Full Text Available Nouf Al-Turki,1 Ayman AM Afify,1 Mohammed AlAteeq2 1Family Medicine Department, Prince Sultan Military Medical City, 2Department of Family Medicine and PHC, King Abdul-Aziz Medical City, National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia Background: Health care violence is a significant worldwide problem with negative consequences on both the safety and well-being of health care workers as well as workplace activities. Reports examining health care violence in Saudi Arabia are limited and the results are conflicting.Objective: To estimate the prevalence and determine the demographic and occupational characteristics associated with workplace violence in primary care centers in Riyadh, Saudi Arabia.Methods: A cross-sectional study included 270 health care workers in 12 family medicine centers in Riyadh during November and December 2014. A structured self-administered questionnaire was used to estimate the frequency, timing, causes, reactions, and consequences of workplace violence plus participants’ demographic and occupational data.Results: A total 123 health care workers (45.6% experienced some kind of violence over 12 months prior to the study. These included physical (6.5% and nonphysical violence (99.2%, including verbal violence (94.3% and intimidation (22.0%. Offenders were patients (71.5% in the majority of cases, companions (20.3%, or both (3.3%. Almost half (48.0% of health care workers who experienced violence did nothing, 38.2% actively reported the event, and 13.8% consulted a colleague. A significant association of workplace violence was found with working multiple shifts, evening or night shift, and lack of an encouraging environment to report violence.Conclusion: Workplace violence is still a significant problem in primary care centers. The high frequency of violence together with underreporting may indicate the inefficiency of the current safety program. More safety programs and training activities for health care
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Analysis of health in health centers area in Depok using correspondence analysis and scan statistic
Basir, C.; Widyaningsih, Y.; Lestari, D.
2017-07-01
Hotspots indicate area that has a higher case intensity than others. For example, in health problems of an area, the number of sickness of a region can be used as parameter and condition of area that determined severity of an area. If this condition is known soon, it can be overcome preventively. Many factors affect the severity level of area. Some health factors to be considered in this study are the number of infant with low birth weight, malnourished children under five years old, under five years old mortality, maternal deaths, births without the help of health personnel, infants without handling the baby's health, and infant without basic immunization. The number of cases is based on every public health center area in Depok. Correspondence analysis provides graphical information about two nominal variables relationship. It create plot based on row and column scores and show categories that have strong relation in a close distance. Scan Statistic method is used to examine hotspot based on some selected variables that occurred in the study area; and Correspondence Analysis is used to picturing association between the regions and variables. Apparently, using SaTScan software, Sukatani health center is obtained as a point hotspot; and Correspondence Analysis method shows health centers and the seven variables have a very significant relationship and the majority of health centers close to all variables, except Cipayung which is distantly related to the number of pregnant mother death. These results can be used as input for the government agencies to upgrade the health level in the area.
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Violence against health workers in Family Medicine Centers
Al-Turki, Nouf; Afify, Ayman AM; AlAteeq, Mohammed
2016-01-01
Background Health care violence is a significant worldwide problem with negative consequences on both the safety and well-being of health care workers as well as workplace activities. Reports examining health care violence in Saudi Arabia are limited and the results are conflicting. Objective To estimate the prevalence and determine the demographic and occupational characteristics associated with workplace violence in primary care centers in Riyadh, Saudi Arabia. Methods A cross-sectional study included 270 health care workers in 12 family medicine centers in Riyadh during November and December 2014. A structured self-administered questionnaire was used to estimate the frequency, timing, causes, reactions, and consequences of workplace violence plus participants’ demographic and occupational data. Results A total 123 health care workers (45.6%) experienced some kind of violence over 12 months prior to the study. These included physical (6.5%) and nonphysical violence (99.2%), including verbal violence (94.3%) and intimidation (22.0%). Offenders were patients (71.5%) in the majority of cases, companions (20.3%), or both (3.3%). Almost half (48.0%) of health care workers who experienced violence did nothing, 38.2% actively reported the event, and 13.8% consulted a colleague. A significant association of workplace violence was found with working multiple shifts, evening or night shift, and lack of an encouraging environment to report violence. Conclusion Workplace violence is still a significant problem in primary care centers. The high frequency of violence together with underreporting may indicate the inefficiency of the current safety program. More safety programs and training activities for health care workers, efficient reporting system, and zero tolerance policies need to be implemented to minimize workplace violence against health workers. PMID:27330300
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Use of an electronic medical record improves the quality of urban pediatric primary care.
Adams, William G; Mann, Adriana M; Bauchner, Howard
2003-03-01
To evaluate the quality of pediatric primary care, including preventive services, before and after the introduction of an electronic medical record (EMR) developed for use in an urban pediatric primary care center. A pre-postintervention analysis was used in the study. The intervention was a pediatric EMR. Routine health care maintenance visits for children eye-to-eye contact with patients was reduced, and 4 of 7 reported that use of the system increased the duration of visits (mean: 9.3 minutes longer). All users recommended continued use of the system. Use of the EMR in this study was associated with improved quality of care. This experience suggests that EMRs can be successfully used in busy urban pediatric primary care centers and, as recommended by the Institute of Medicine, must play a central role in the redesign of the US health care system.
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Directory of Open Access Journals (Sweden)
Asma Perveen
2017-09-01
Full Text Available Objective: The purpose of this study was to explore the prevalence of psychological disorders among community health centers in Batang Padang district Perak. Material & Methods: To conduct this study survey research method was used, seven community health centers in Batang Padang District, Perak were contacted to collect data from (N=216 respondents, who attended health facilities in Batang Padang District. There is no age limit, no education difference and no other requirement needed. Instrument and Materials: Depression, Anxiety and Stress Scale (DASS-21 PRIME Screen and PRIME MD Patient Health Questionnaire (PHQ. Results: Data collected from seven health community centers revealed that prevalence of Stress 86%, anxiety 124%, depression 67, psychotic symptoms 16%, somatoform symptoms 52%, panic symptoms 28%, and substance abuse 21%. the higher prevalence was stress and depression among people attending health centers. Conclusion: Results findings indicated that there is significant prevalence of psychological disorder among community health centers. Analysis of the results help us to determine that there is strong need to provide psychological services, awareness and education plan, management and prevention for psychological disorders
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Directory of Open Access Journals (Sweden)
Ilona Małuszyńska
2014-10-01
Full Text Available Urban areas are exposed on those originating in various sources, emissions of pollutants that pose a threat to the health of living organisms. The type of pollutant and its toxicity to organisms and mold exposure as well as the frequency of their occurrence in the environment can have a negative impact on living organisms occurring in the area. Another element negatively affecting the environmental health is a rush of individuals and communities to prosperity, which, combined with a weak nervous resistance to stressful situations contributes to the reduction of resistance to disease becoming the scourge of society as bulimia, diabetes and cancer. The tendency to increase building occurring in urban areas and the increasing number of urban dwellers in Europe as well as increasing awareness of the population about the need to protect environmental health, points to the need to seek alternative and innovative solutions for urban greenery. Investments included in that group, the green roofs and green walls, the implementation of which will increase the biologically active surface in the cities, may be an essential element of urban infrastructure that contributes to improving the quality of life of communities living in the city.
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Directory of Open Access Journals (Sweden)
Inaam Albazzaz
2017-12-01
Full Text Available The research represents an applied study to the urban scene of Baghdad city center within the area of (Al Bab Al Sharqi – Al Tahrir Square through studying and identifying the levels of the reciprocal correlation of advertising signs impact on urban scene , then finding out the indicators and potential values which have made advertising signs as positive value by achieving the mechanisms of visual quality or a negative value by achieving mechanisms of visual pollution. And then examining the resulted visual perception defect reforming mechanism from it and identify the basic elements represented of the laws and legislation known worldwide. When presenting the problem, The research depends on: (Lack of clear perception about the definition of advertising signs concept and their design characteristics (Semantic impact on achieving the relationship of perceptual contact with the individual (recipient in addition to its contribution in enhancing the visual quality and reducing the visual pollution situation on urban scene of the cities centers. In order to solve the research problem, the objective outlined as follows: (Reaching to building up an integrated theoretical model, by which the foundations and mechanisms of the main act of advertising signs are determined as communication and perception act between the individual (recipient and urban scene , and their impact level on the scene in accordance with the concept of visual quality and visual pollution. The research hypothesis is as follows: (Lack of harmony in the advertising signs' design characteristics (Semantic affects the efficiency of their performance as a communicational and perceptual act, and on diminishing the visual quality and increasing the visual pollution situation in urban scene of cities centers. The research reached to a number of conclusions, mainly: Baghdad city center (represented by study area suffers visual pollution caused by misuse of advertising signs as a result of
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Public health implications of urban air pollution in developing countries
Energy Technology Data Exchange (ETDEWEB)
Schwela, D.H. [World Health Organisation, Geneva (Switzerland)
1995-12-31
Exposure to air pollution is an almost inescapable part of urban life throughout the world. Ambient air pollutant levels in urban areas are generally a reflection of emissions. For sulphur dioxide, total suspended particulate matter and lead, ambient concentrations are declining in the industrialized western countries. For nitrogen dioxide, ambient levels in cities are generally constant, or slightly increasing. For carbon dioxide, they are variable, declining where controls are being applied. In a substantial number of cities, particularly in developing countries, WHO guidelines are being often exceeded for the compounds mentioned. Given the rate at which these cities are growing, the air pollution situation will probably worsen if environmental control measures are not implemented. As a consequence, the health and well-being of urban residents will further deteriorate with high ambient air pollutant concentrations causing increased mortality, morbidity, deficits on pulmonary functions and cardiovascular and neurobehavioural effects. (author)
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Public health implications of urban air pollution in developing countries
Energy Technology Data Exchange (ETDEWEB)
Schwela, D H [World Health Organisation, Geneva (Switzerland)
1996-12-31
Exposure to air pollution is an almost inescapable part of urban life throughout the world. Ambient air pollutant levels in urban areas are generally a reflection of emissions. For sulphur dioxide, total suspended particulate matter and lead, ambient concentrations are declining in the industrialized western countries. For nitrogen dioxide, ambient levels in cities are generally constant, or slightly increasing. For carbon dioxide, they are variable, declining where controls are being applied. In a substantial number of cities, particularly in developing countries, WHO guidelines are being often exceeded for the compounds mentioned. Given the rate at which these cities are growing, the air pollution situation will probably worsen if environmental control measures are not implemented. As a consequence, the health and well-being of urban residents will further deteriorate with high ambient air pollutant concentrations causing increased mortality, morbidity, deficits on pulmonary functions and cardiovascular and neurobehavioural effects. (author)
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Smit, Warren; Hancock, Trevor; Kumaresen, Jacob; Santos-Burgoa, Carlos; Sánchez-Kobashi Meneses, Raúl; Friel, Sharon
2011-01-01
The importance of reestablishing the link between urban planning and public health has been recognized in recent decades; this paper focuses on the relationship between urban planning/design and health equity, especially in cities in low and middle-income countries (LMICs). The physical urban environment can be shaped through various planning and design processes including urban planning, urban design, landscape architecture, infrastructure design, architecture, and transport planning. The re...
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Building diversity in a complex academic health center.
South-Paul, Jeannette E; Roth, Loren; Davis, Paula K; Chen, Terence; Roman, Anna; Murrell, Audrey; Pettigrew, Chenits; Castleberry-Singleton, Candi; Schuman, Joel
2013-09-01
For 30 years, the many diversity-related health sciences programs targeting the University of Pittsburgh undergraduate campus, school of medicine, schools of the health sciences, clinical practice plan, and medical center were run independently and remained separate within the academic health center (AHC). This lack of coordination hampered their overall effectiveness in promoting diversity and inclusion. In 2007, a group of faculty and administrators from the university and the medical center recognized the need to improve institutional diversity and to better address local health disparities. In this article, the authors describe the process of linking the efforts of these institutions in a way that would be successful locally and applicable to other academic environments. First, they engaged an independent consultant to conduct a study of the AHC's diversity climate, interviewing current and former faculty and trainees to define the problem and identify areas for improvement. Next, they created the Physician Inclusion Council to address the findings of this study and to coordinate future efforts with institutional leaders. Finally, they formed four working committees to address (1) communications and outreach, (2) cultural competency, (3) recruitment, and (4) mentoring and retention. These committees oversaw the strategic development and implementation of all diversity and inclusion efforts. Together these steps led to structural changes within the AHC and the improved allocation of resources that have positioned the University of Pittsburgh to achieve not only diversity but also inclusion and to continue to address the health disparities in the Pittsburgh community.
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Health status and air pollution related socioeconomic concerns in urban China.
Jiao, Kaishan; Xu, Mengjia; Liu, Meng
2018-02-05
China is experiencing environmental issues and related health effects due to its industrialization and urbanization. The health effects associated with air pollution are not just a matter of epidemiology and environmental science research, but also an important social science issue. Literature about the relationship of socioeconomic factors with the environment and health factors is inadequate. The relationship between air pollution exposure and health effects in China was investigated with consideration of the socioeconomic factors. Based on nationwide survey data of China in 2014, we applied the multilevel mixed-effects model to evaluate how socioeconomic status (represented by education and income) contributed to the relationship between self-rated air pollution and self-rated health status at community level and individual level. The findings indicated that there was a non-linear relationship between the community socioeconomic status and community air pollution in urban China, with the highest level of air pollution presented in the communities with moderate socioeconomic status. In addition, health effects associated air pollution in different socioeconomic status groups were not equal. Self-rated air pollution had the greatest impact on self-rated health of the lower socioeconomic groups. With the increase of socioeconomic status, the effect of self-rated air pollution on self-rated health decreased. This study verified the different levels of exposure to air pollution and inequality in health effects among different socioeconomic groups in China. It is imperative for the government to urgently formulate public policies to enhance the ability of the lower socioeconomic groups to circumvent air pollution and reduce the health damage caused by air pollution.
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75 FR 12766 - National Center on Minority Health and Health Disparities; Notice of Closed Meetings
2010-03-17
... Health and Health Disparities; Notice of Closed Meetings Pursuant to section 10(d) of the Federal... and Health Disparities Special Emphasis Panel Loan Repayment Program for Health Disparities Research... Review, National Center on Minority Health and Health Disparities, 6707 Democracy Boulevard, Suite 800...
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Health and climate related ecosystem services provided by street trees in the urban environment.
Salmond, Jennifer A; Tadaki, Marc; Vardoulakis, Sotiris; Arbuthnott, Katherine; Coutts, Andrew; Demuzere, Matthias; Dirks, Kim N; Heaviside, Clare; Lim, Shanon; Macintyre, Helen; McInnes, Rachel N; Wheeler, Benedict W
2016-03-08
Urban tree planting initiatives are being actively promoted as a planning tool to enable urban areas to adapt to and mitigate against climate change, enhance urban sustainability and improve human health and well-being. However, opportunities for creating new areas of green space within cities are often limited and tree planting initiatives may be constrained to kerbside locations. At this scale, the net impact of trees on human health and the local environment is less clear, and generalised approaches for evaluating their impact are not well developed.In this review, we use an urban ecosystems services framework to evaluate the direct, and locally-generated, ecosystems services and disservices provided by street trees. We focus our review on the services of major importance to human health and well-being which include 'climate regulation', 'air quality regulation' and 'aesthetics and cultural services'. These are themes that are commonly used to justify new street tree or street tree retention initiatives. We argue that current scientific understanding of the impact of street trees on human health and the urban environment has been limited by predominantly regional-scale reductionist approaches which consider vegetation generally and/or single out individual services or impacts without considering the wider synergistic impacts of street trees on urban ecosystems. This can lead planners and policymakers towards decision making based on single parameter optimisation strategies which may be problematic when a single intervention offers different outcomes and has multiple effects and potential trade-offs in different places.We suggest that a holistic approach is required to evaluate the services and disservices provided by street trees at different scales. We provide information to guide decision makers and planners in their attempts to evaluate the value of vegetation in their local setting. We show that by ensuring that the specific aim of the intervention, the
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Sexual Violence Screening Practices of Student Health Centers Located on Universities in Florida
Halstead, Valerie; Williams, Jessica R.; Gattamorta, Karina; Gonzalez-Guarda, Rosa
2017-01-01
Objective: The purpose of this study is to describe current sexual violence screening practices of student health centers located on universities in Florida. Participants: Institutional level data was collected from 33 student health centers from November 2015 through January 2016. The student health centers were located on public or private…
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Weight- and race-based bullying: health associations among urban adolescents.
Rosenthal, Lisa; Earnshaw, Valerie A; Carroll-Scott, Amy; Henderson, Kathryn E; Peters, Susan M; McCaslin, Catherine; Ickovics, Jeannette R
2015-04-01
Stigma-based bullying is associated with negative mental and physical health outcomes. In a longitudinal study, surveys and physical assessments were conducted with mostly Black and Latino, socioeconomically disadvantaged, urban students. As hypothesized, greater weight- and race-based bullying each was significantly indirectly associated with increased blood pressure and body mass index, as well as decreased overall self-rated health across 2 years, through the mechanism of more negative emotional symptoms. Results support important avenues for future research on mechanisms and longitudinal associations of stigma-based bullying with health. Interventions are needed to reduce stigma-based bullying and buffer adolescents from adverse health effects. © The Author(s) 2013.
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78 FR 78966 - Board of Scientific Counselors, National Center for Health Statistics
2013-12-27
... Scientific Counselors, National Center for Health Statistics In accordance with section 10(a)(2) of the...), National Center for Health Statistics (NCHS) announces the following meeting of the aforementioned..., NCHS; discussion of vital statistics; future program reviews; National Health Interview Survey 2017...
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Clauss-Ehlers, Caroline C. C.
2003-01-01
Discusses the demographic realities of children of color in the U.S., with a focus on health care needs and access issues that have an enormous influence on health status. An ecologic model is presented that incorporates cultural values and community structures into the school health center. (Contains 50 references.) (GCP)
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Managing rapid urbanization in the third world: some aspects of policy.
Hope, K R
1989-01-01
A priority task for developing countries is the formulation of national urbanization policies that: 1) foster the full development of national resources; 2) promote cohesion among regions, especially where there are striking inequities in per capita output; 3) prevent or correct the overconcentration of economic activity in a few urban centers; and 4) create a more efficient, equitable management of growth within cities. Although urban households tend to be served better by the health and educational sectors than their rural counterparts, the urban poor are denied these benefits in the absence of special programs to ensure universal access. The urban poor are further denied access to the benefits of urban centers through a transportation policy that is oriented more toward roads and cars than public transit systems. Of major concern are the overcrowded squatter settlements that have developed in response to massive rural-urban migration. Since the landlessness, joblessness, and demoralization in rural areas and the consequent urban influx are at the root of the urban crisis in the Third World, integrated rural development is essential to retain substantial new additions to the urban labor force in rural areas. Land reform is the single strategy with the greatest potential to improve the quality of life of the landless poor and small holders. Other needs include programs of labor-intensive rural public works to provide supplementary income-earning opportunities and improve the rural infrastructure and more widespread participation of the rural poor in the development process. Increasingly sophisticated administrative and financing systems will be required to carry out a national urbanization policy, and current politicized bureaucracies must be replaced by a reliance on technically skilled professional administrators.
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Directory of Open Access Journals (Sweden)
Yuhan Rui
2018-02-01
Full Text Available Climate change and urbanization have led to an increase in the frequency of extreme water related events such as flooding, which has negative impacts on the environment, economy and human health. With respect to the latter, our understanding of the interrelationship between flooding, urban surface water and human health is still very limited. More in-depth research in this area is needed to further strengthen the process of planning and implementation of responses to mitigate the negative health impacts of flooding in urban areas. The objective of this paper is to assess the state of the research on the interrelationship between surface water quality, flood water quality and human health in urban areas based on the published literature. These insights will be instrumental in identifying and prioritizing future research needs in this area. In this study, research publications in the domain of urban flooding, surface water quality and human health were collated using keyword searches. A detailed assessment of these publications substantiated the limited number of publications focusing on the link between flooding and human health. There was also an uneven geographical distribution of the study areas, as most of the studies focused on developed countries. A few studies have focused on developing countries, although the severity of water quality issues is higher in these countries. The study also revealed a disparity of research in this field across regions in China as most of the studies focused on the populous south-eastern region of China. The lack of studies in some regions has been attributed to the absence of flood water quality monitoring systems which allow the collection of real-time water quality monitoring data during flooding in urban areas. The widespread implementation of cost effective real-time water quality monitoring systems which are based on the latest remote or mobile phone based data acquisition techniques is recommended
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Chen, Hongsheng; Liu, Ye; Zhu, Zhenjun; Li, Zhigang
2017-04-21
China's rapid urbanization over the past decades has exacerbated the problems of environmental degradation and health disparities. However, few studies have analysed the differences between urban and rural residents in relation to how environmental quality impacts health outcomes. This study examines the associations between Chinese people's perceptions of environmental quality and their self-rated health, particularly focusing on differences between rural and urban residents in environment-health relationships. Using a logistic regression model and data from the 2013 Chinese General Social Survey (CGSS), a representative sample of data for 3,402 urban residents (46 ± 16 years) and 2,439 rural residents (48 ± 15 years) was analysed. The dependent variable used for the logistic regressions was whether or not respondents reported being healthy. Independent variables included respondents' evaluations of the living environment, and how frequently they participated in physical activities. Interaction terms were employed to measure the moderating effects of physical exercise on the relationship between perceived environmental quality and health. The percentage of healthy urban residents was significantly larger than that of healthy rural respondents (70.87% versus 62.87%). Urban respondents living in areas with sufficient green space were more likely to report good health (OR = 0.749, CI = [0.628, 0.895]), while rural respondents without reliable access to fresh water were more likely to report poor health (OR = 0.762, CI = [0.612, 0.949]). Urban respondents who were exposed to green spaces and exercised frequently were 21.6 per cent more likely to report good health than those who exercised infrequently (OR = 1.216, CI = [1.047, 1.413]). Those who lived in areas with insufficient green space and exercised frequently were 19.1 per cent less likely to report good health than those who exercised infrequently (OR = 0.805, CI = [0
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Outcomes of antiretroviral treatment: a comparison between hospitals and health centers in Ethiopia.
Balcha, Taye T; Jeppsson, Anders
2010-01-01
the objective of this study was to compare the outcomes of antiretroviral therapy (ART) between hospital and health center levels in Ethiopia. medical records of 1709 ART patients followed for 24 months at 2 hospitals and 3 health centers in the Oromia region of Ethiopia were reviewed. Noted outcomes of ART were currently alive and on treatment; lost to follow-up (LTFU); transferred out (TO); and died (D). of 1709 HIV-positive patients started on ART between September 2006 and February 2007, 1044 (61%) remained alive and were on treatment after 24-month follow-up. In all, 835 (57%) of ART patients at hospitals and 209 (83%) at health centers were retained in the program. Of those who were alive and receiving ART, 79% of patients at health centers and 72% at hospitals were clinically or immunologically improving. In addition, 331 (23%) patients at hospitals were LFTU as compared to 24 (10%) of patients at health centers (relative risk [RR] at 95% confidence interval [CI]: .358 [.231-.555]). While 11% was the mortality rate at hospitals, 5% of patients at health centers also died (RR at 95% CI: .360 [.192-.673]). antiretroviral therapy at health centers was associated with more favorable outcomes than at hospitals.
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Directory of Open Access Journals (Sweden)
Jo Vearey
2017-07-01
Full Text Available Abstract Johannesburg is home to a diverse migrant population and a range of urban health challenges. Locally informed and implemented responses to migration and health that are sensitive to the particular needs of diverse migrant groups are urgently required. In the absence of a coordinated response to migration and health in the city, the Johannesburg Migrant Health Forum (MHF – an unfunded informal working group of civil society actors – was established in 2008. We assess the impact, contributions and challenges of the MHF on the development of local-level responses to migration and urban health in Johannesburg to date. In this Commentary, we draw on data from participant observation in MHF meetings and activities, a review of core MHF documents, and semi-structured interviews conducted with 15 MHF members. The MHF is contributing to the development of local-level migration and health responses in Johannesburg in three key ways: (1 tracking poor quality or denial of public services to migrants; (2 diverse organisational membership linking the policy process with community experiences; and (3 improving service delivery to migrant clients through participation of diverse service providers and civil society organisations in the Forum. Our findings indicate that the MHF has a vital role to play in supporting the development of appropriate local responses to migration and health in a context of continued – and increasing – migration, and against the backdrop of rising anti-immigrant sentiments.
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75 FR 9421 - National Center on Minority Health and Health Disparities; Notice of Closed Meeting
2010-03-02
... Health and Health Disparities; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... and Health Disparities Special Emphasis Panel; Loan Repayment Program for Health Disparities Research..., National Center on Minority Health and Health Disparities, 6707 Democracy Boulevard, Suite 800, Bethesda...
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Community Life as a Motive for Migration from the Urban Center to the Rural Periphery in Israel
Arnon, Sara; Shamai, Shmuel
2010-01-01
A white house topped by a red roof, set in a garden, surrounded by a lawn dotted with trees and shrubs--this is not just a child's naive drawing. It is the aspiration of many in the modern world, Israelis among them. This case study deals with the inner migration of families, mainly from the urban center of Israel, to rural communities in its…
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Xiong, Juyang; Hipgrave, David; Myklebust, Karoline; Guo, Sufang; Scherpbier, Robert W; Tong, Xuetao; Yao, Lan; Moran, Andrew E
2013-11-01
China embarked on an ambitious health system reform in 2009, and pledged to achieve universal health insurance coverage by 2020. However, there are gaps in access to healthcare for some children in China. We assessed health insurance status and associated variables among children under five in twelve communities in 2010: two urban community health centers and two rural township health centers in each of three municipalities located in China's distinctly different East, Central and Western regions. Information on demographic and socio-economic variables and children's insurance status was gathered from parents or caregivers of all children enrolled in local health programs, and others recruited from the local communities. Only 62% of 1131 children assessed were insured. This figure did not vary across geographic regions, but urban children were less likely to be insured than rural children. In multivariate analysis, infants were 2.44 times more likely to be uninsured than older children and children having at least one migrant parent were 1.90 times more likely to be uninsured than those living with non-migrant parents. Low maternal education was also associated with being uninsured. Gaps in China's child health insurance coverage might be bridged if newborns are automatically covered from birth, and if insurance is extended to all urban migrant children, regardless of the family's residential registration status and size. Copyright © 2013 Elsevier Ltd. All rights reserved.
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International Nuclear Information System (INIS)
Obinaju, Blessing E.; Martin, Francis L.
2013-01-01
Biospectroscopy is an emerging inter-disciplinary field that exploits the application of sensor technologies [e.g., Fourier-transform infrared spectroscopy, Raman spectroscopy] to lend novel insights into biological questions. Methods involved are relatively non-destructive so samples can subsequently be analysed by more conventional approaches, facilitating deeper mechanistic insights. Fingerprint spectra are derived and these consist of wavenumber–absorbance intensities; within a typical biological experiment, a complex dataset is quickly generated. Biological samples range from biofluids to cytology to tissues derived from human or sentinel sources, and analyses can be carried out ex vivo or in situ in living tissue. A reference range of a designated normal state can be derived; anything outside this is potentially atypical and discriminating chemical entities identified. Computational approaches allow one to minimize within-category confounding factors. Because of ease of sample preparation, low-cost and high-throughput capability, biospectroscopy approaches herald a new greener means of environmental health monitoring in urban environments. -- Highlights: ► Biospectroscopy is an emerging inter-disciplinary field. ► Physical sciences sensors with computational tools lend novel insights into biology. ► Analyse in a non-destructive manner; correlate with conventional methodologies. ► Low-cost, high-throughput and label-free (i.e., a green) technology. ► Can be applied to environmental health monitoring in urban environments. -- Biospectroscopy techniques allow the fingerprinting of biological material in a wide range of contexts that could relate to environmental health monitoring in urban environments
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Politi, Mary C; Estlund, Amy; Milne, Anne; Buckel, Christina M; Peipert, Jeffrey F; Madden, Tessa
2016-01-01
The Contraceptive CHOICE Project developed a patient-centered model for contraceptive provision including: (1) structured, evidence-based counseling; (2) staff and health care provider education; and (3) removal of barriers such as cost and multiple appointments to initiate contraception. In preparation for conducting a research study of the CHOICE model in three community health settings, we sought to identify potential barriers and facilitators to implementation. Using a semi-structured interview guide guided by a framework of implementation research, we conducted 31 qualitative interviews with female patients, staff, and health care providers assessing attitudes, beliefs, and barriers to receiving contraception. We also asked about current contraceptive provision and explored organizational practices relevant to implementing the CHOICE model. We used a grounded theory approach to identify major themes. Many participants felt that current contraceptive provision could be improved by the CHOICE model. Potential facilitators included agreement about the necessity for improved contraceptive knowledge among patients and staff; importance of patient-centered contraceptive counseling; and benefits to same-day insertion of long-acting reversible contraception (LARC). Potential barriers included misconceptions about contraception held by staff and providers; resistance to new practices; costs associated with LARC; and scheduling challenges required for same-day insertion of LARC. In addition to staff and provider training, implementing a patient-centered model of contraceptive provision needs to be supplemented by strategies to manage patient and system-level barriers. Community health center staff, providers, and patients support patient-centered contraceptive counseling to improve contraception provision if organizations can address these barriers.
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Fine-Scale Environmental Indicators of Public Health and Well-Being for Urban Communities
Urban ecosystem services contribute to public health and well-being by buffering natural and man-made hazards, and by promoting healthful lifestyles that include physical activity, social interaction, and engagement with nature. As part of the EnviroAtlas online mapping tool, EP...
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Assessment of Soil Health in Urban Agriculture: Soil Enzymes and Microbial Properties
Directory of Open Access Journals (Sweden)
Avanthi Deshani Igalavithana
2017-02-01
Full Text Available Urban agriculture has been recently highlighted with the increased importance for recreation in modern society; however, soil quality and public health may not be guaranteed because of continuous exposure to various pollutants. The objective of this study was to evaluate the soil quality of urban agriculture by soil microbial assessments. Two independent variables, organic and inorganic fertilizers, were considered. The activities of soil enzymes including dehydrogenase, β-glucosidase, arylsulfatase, urease, alkaline and acid phosphatases were used as indicators of important microbial mediated functions and the soil chemical properties were measured in the soils applied with organic or inorganic fertilizer for 10 years. Fatty acid methyl ester analysis was applied to determine the soil microbial community composition. Relatively higher microbial community richness and enzyme activities were found in the organic fertilizers applied soils as compared to the inorganic fertilizers applied soils. Principal component analysis explained the positive influence of organic fertilizers on the microbial community. The application of organic fertilizers can be a better alternative compared to inorganic fertilizers for the long-term health and security of urban agriculture.
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77 FR 37415 - Office of Urban Indian Health Programs; Title V HIV/AIDS Program
2012-06-21
... Indian health program HIV/AIDS activities is necessary to reduce the incidence of HIV/AIDS in the urban Indian communities by increasing access to HIV related services, reducing stigma, and making testing..., Substance Abuse and Mental Health Services Administration, Health Resource and Services Administration, and...
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The Rise of Urban Centers in the Golden Horde and the City of Ükek
Directory of Open Access Journals (Sweden)
Uli Schamiloglu
2018-03-01
Full Text Available Research objectives and materials: This essay discusses the rise of cities in the territories of the Golden Horde. It contextualizes the information found in European travelers such as Marco Polo and William of Rubruck to examine the transition from a nomadic economy to a sedentary economy. Arabic sources such as Abū l‑Fidā allow a survey of the location of the major urban centers while Ibn Baṭṭūṭa allows a deeper understanding of the composition of cities. While Ukek started as an urban center situated at the northern limit of the annual nomadic migration route and midway between the capital city Saray in the south and the city of Bulgar in the north, the essay argues that it is likely that it later gained in importance as a center for grain production as the result of climate change. It also attempts to understand the origin and meaning of the name Ukek, for the etymology of which it offers a detailed examination of medieval and modern data. Results and novelty of the research: The essay proposes that the name Ukek actually relays information about the geological formation of the site on which it is built. While most scholars have understood the original meaning of ‘box’ to represent fortifications built on the city wall, the author argues that the name refers rather to the boxlike hollow shape of the formation, which offered both shelter and an elevated location which would be both visible to travelers as well as a shape easily recognized by travelers coming from thousands of kilometers from the southeast, where there were several other such formations carrying the same name.
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Child health inequities in developing countries: differences across urban and rural areas
Fotso Jean-Christophe
2006-01-01
Abstract Objectives To document and compare the magnitude of inequities in child malnutrition across urban and rural areas, and to investigate the extent to which within-urban disparities in child malnutrition are accounted for by the characteristics of communities, households and individuals. Methods The most recent data sets available from the Demographic and Health Surveys (DHS) of 15 countries in sub-Saharan Africa (SSA) are used. The selection criteria were set to ensure that the number ...
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NASA Human Health and Performance Center (NHHPC)
Davis, Jeffery R.
2010-01-01
This slide presentation reviews the purpose, potential members and participants of the NASA Human Health and Performance Center (NHHPC). Included in the overview is a brief description of the administration and current activities of the NHHPC.
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The intersection of urban planning, art, and public health: the Sunnyside Piazza.
Semenza, Jan C
2003-09-01
Deteriorating physical features of urban environments can negatively influence public health. Dilapidated environments and urban blight tend to promote alienation and can be associated with social disorder, vandalism, crime, drug abuse, traffic violations, and littering, which in turn affects health and well-being. In the late 1990s, the Sunnyside neighborhood in Portland, Ore, was plagued by many of these problems. In an attempt to invigorate neighborhood stewardship, the community organized and created a public gathering place; together, they painted a gigantic sunflower in the middle of an intersection and installed several interactive art features. As a result of these collective actions of "place-making," social capital has increased, thus revitalizing the community, and expanded social networks among residents have stimulated a sense of well-being.
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Health Care Employee Perceptions of Patient-Centered Care: A Photovoice Project
Balbale, Salva Najib; Turcios, Stephanie; LaVela, Sherri L.
2015-01-01
Given the importance of health care employees in the delivery of patient-centered care, understanding their unique perspective is essential for quality improvement. The purpose of this study was to use photovoice to evaluate perceptions and experiences around patient-centered care among Veterans Affairs (VA) health care employees. We asked participants to take photographs of salient features in their environment related to patient-centered care. We used the photographs to facilitate dialogue during follow-up interviews. Twelve VA health care employees across two VA sites participated in the project. Although most participants felt satisfied with their work environment and experiences at the VA, several areas for improvement were identified. These included a need for more employee health and wellness initiatives and a need for enhanced opportunities for training and professional growth. Application of photovoice enabled us to learn about employees' unique perspectives around patient-centered care while engaging them in an evaluation of care delivery. PMID:25274626
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Urban tree effects on fine particulate matter and human health
David J. Nowak
2014-01-01
Overall, city trees reduce particulate matter and provide substantial health benefits; but under certain conditions, they can locally increase particulate matter concentrations. Urban foresters need to understand how trees affect particulate matter so they can select proper species and create appropriate designs to improve air quality. This article details trees'...
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Medicaid Expansion And Grant Funding Increases Helped Improve Community Health Center Capacity.
Han, Xinxin; Luo, Qian; Ku, Leighton
2017-01-01
Through the expansion of Medicaid eligibility and increases in core federal grant funding, the Affordable Care Act (ACA) sought to increase the capacity of community health centers to provide primary care to low-income populations. We examined the effects of the ACA Medicaid expansion and changes in federal grant levels on the centers' numbers of patients, percentages of patients by type of insurance, and numbers of visits from 2012 to 2015. In the period after expansion (2014-15), health centers in expansion states had a 5 percent higher total patient volume, larger shares of Medicaid patients, smaller shares of uninsured patients, and increases in overall visits and mental health visits, compared to centers in nonexpansion states. Increases in federal grant funding levels were associated with increases in numbers of patients and of overall, medical, and preventive service visits. If federal grant levels are not sustained after 2017, there could be marked reductions in health center capacity in both expansion and nonexpansion states. Project HOPE—The People-to-People Health Foundation, Inc.
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Environment and Its Influence on Health and Demographics in South Korea.
Bravo Santisteban, Ramiro D; Kim, Young L; Farooq, Umar; Kim, Tae-Seong; Youm, Sekyoung; Park, Seung-Hun
2016-02-04
As the prevalence of overweight and obesity has been increasing in South Korea, it is critical to better understand possible associations between environmental surroundings and general health status. We characterize key health test readings and basic demographic information from 10,816 South Koreans, obtained from two Ubiquitous Healthcare (U-Healthcare) centers that have distinct surrounding neighborhood characteristics. One is located in a rural area in Busan, the other is located in an urban area in Daegu surrounded by a highly crowded residential and commercial business area. We analyze comprehensive health data sets, including blood pressure, body mass index, pulse rate, and body fat percentage from December 2013 to December 2014 to study differences in overall health test measurements between users of rural and urban U-Healthcare centers. We conduct multiple regression analyses to evaluate differences in general health status between the two centers, adjusting for confounding factors. We report statistical evidence of differences in blood pressure at the two locations. As local residents are major users, the result indicates that the environmental surroundings of the centers can influence the demographics of the users, the type of health tests in demand, and the users' health status. We further envision that U-Healthcare centers will provide public users with an opportunity for enhancing their current health, which could potentially be used to prevent them from developing chronic diseases, while providing surveillance healthcare data.
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Adolescent health promotion based on community-centered arts education
Directory of Open Access Journals (Sweden)
Anny Giselly Milhome da Costa Farre
Full Text Available ABSTRACT Objective: To evaluate the contribution of arts education to health promotion of adolescents in situations of urban social vulnerability. Method: Participatory evaluative research, with a qualitative approach, using as a reference the theoretical constructs of Paulo Freire's Conscientization and the Empowerment Evaluation as a method of collecting with adolescents and teachers of an arts education program in the field of the Family Health Strategy. Results: Participants constructed a collective mission that represented the concept of adolescent health promotion. Arts education activities were prioritized and ranked with a mission focus, and over a three-month period, the program implemented health goals through art. In the reevaluation, the group presented a broad look at the implementation of activities and self-determination for change. Final considerations: Arts education is a potential space for nurses to act in the conscientization and empowerment of adolescent health in Primary Health Care.
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Holistic Health Care for the Medically Uninsured: The Church Health Center of Memphis
Morris, G. Scott
2015-01-01
The Church Health Center (CHC) in Memphis was founded in 1987 to provide quality, affordable health care for working, uninsured people and their families. With numerous, dedicated financial supporters and health care volunteers, CHC has become the largest faith-based health care organization of its type nationally, serving >61,000 patients. CHC embraces a holistic approach to health by promoting wellness in every dimension of life. It offers on-site services including medical care, dentistry,...
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Assessing the public health impact of using poison center data for public health surveillance.
Wang, Alice; Law, Royal; Lyons, Rebecca; Choudhary, Ekta; Wolkin, Amy; Schier, Joshua
2017-12-13
The National Poison Data System (NPDS) is a database and surveillance system for US poison centers (PCs) call data. The Centers for Disease Control and Prevention (CDC) and American Association of Poison Control Centers (AAPCC) use NPDS to identify incidents of potential public health significance. State health departments are notified by CDC of incidents identified by NPDS to be of potential public health significance. Our objective was to describe the public health impact of CDC's notifications and the use of NPDS data for surveillance. We described how NPDS data informed three public health responses: the Deepwater Horizon incident, national exposures to laundry detergent pods, and national exposures to e-cigarettes. Additionally, we extracted survey results of state epidemiologists regarding NPDS incident notification follow-up from 1 January 2015 to 31 December 2016 to assess current public health application of NPDS data using Epi Info 7.2 and analyzed data using SAS 9.3. We assessed whether state health departments were aware of incidents before notification, what actions were taken, and whether CDC notifications contributed to actions. NPDS data provided evidence for industry changes to improve laundry detergent pod containers safety and highlighted the need to regulate e-cigarette sale and manufacturing. NPDS data were used to improve situational awareness during the 2010 Deepwater Horizon oil spill. Of 59 health departments and PCs who responded to CDC notifications about anomalies (response rate = 49.2%), 27 (46%) reported no previous awareness of the incident, and 20 (34%) said that notifications contributed to public health action. Monitoring NPDS data for anomalies can identify emerging public health threats and provide evidence-based science to support public health action and policy changes.
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Schneider, John; Makelarski, Jennifer A; Van Haitsma, Martha; Lipton, Rebecca B; Abramsohn, Emily; Lauderdale, Diane S; Lindau, Stacy Tessler
2011-06-01
Digital communication technologies (DCT), such as cell phones and the internet, have begun to replace more traditional technologies even in technology-poor communities. We characterized access to DCT in an underserved urban population and whether access is associated with health and study participation. A general probability community sample and a purposive high-turnover housing sample were recruited and re-interviewed after 3 months. Selected characteristics were compared by sample type and retention. Associations between DCT access and self-reported health were examined using multivariable logistic regression. Of 363 eligible individuals, 184 (general community = 119; high-turnover housing = 65) completed the baseline survey. Eighty-four percent of respondents had a cell phone and 62% had ever texted. Ever use of the internet was high (69%) overall, but frequency and years of internet use were higher in the general community sample. Self-reported fair or poor health was more common for residents of cell phone-only households and those with less frequent internet use. Technology use was similar for those retained and not retained. Overall, access to DCT was high in this underserved urban population but varied by sample type. Health varied significantly by DCT use, but study retention did not. These data have implications for incorporating DCT into health-related research in urban populations.
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Ren, Yuan; Qu, Zelong; Du, Yuanyuan; Xu, Ronghua; Ma, Danping; Yang, Guofu; Shi, Yan; Fan, Xing; Tani, Akira; Guo, Peipei; Ge, Ying; Chang, Jie
2017-11-01
Biogenic volatile organic compounds (BVOCs) emissions lead to fine particulate matter (PM 2.5 ) and ground-level ozone pollution, and are harmful to human health, especially in urban areas. However, most BVOCs estimations ignored the emissions from urban green spaces, causing inaccuracies in the understanding of regional BVOCs emissions and their environmental and health effects. In this study, we used the latest local vegetation datasets from our field survey and applied an estimation model to analyze the spatial-temporal patterns, air quality impacts, health damage and mitigating strategies of BVOCs emissions in the Greater Beijing Area. Results showed that: (1) the urban core was the hotspot of regional BVOCs emissions for the highest region-based emission intensity (3.0 g C m -2 yr -1 ) among the 11 sub-regions; (2) urban green spaces played much more important roles (account for 62% of total health damage) than rural forests in threating human health; (3) BVOCs emissions from green spaces will more than triple by 2050 due to urban area expansion, tree growth and environmental changes; and (4) adopting proactive management (e.g. adjusting tree species composition) can reduce 61% of the BVOCs emissions and 50% of the health damage related to BVOCs emissions by 2050. Copyright © 2017 Elsevier Ltd. All rights reserved.
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Intention and Usage of Computer Based Information Systems in Primary Health Centers
Hosizah; Kuntoro; Basuki N., Hari
2016-01-01
The computer-based information system (CBIS) is adopted by almost all of in health care setting, including the primary health center in East Java Province Indonesia. Some of softwares available were SIMPUS, SIMPUSTRONIK, SIKDA Generik, e-puskesmas. Unfortunately they were most of the primary health center did not successfully implemented. This…
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Directory of Open Access Journals (Sweden)
Arun Singh Thakur
2017-01-01
Full Text Available Objectives: The objective of this study is to assess the oral health status and oral health behavior among 12-year-old urban and rural school children and to evaluate the relative effect of sociobehavioral risk factors on caries experience. Materials and Methods: A cross-sectional study was conducted which included urban and rural subgroups of 12-year-old school children. The final study population covered two groups: 12 years rural (n = 261 and urban school children (n = 264. Data were collected and compared using Chi-square test. Logistic regression analysis was done to assess the importance of variables associated with dental caries. Results: Highly significant differences (P < 0.001 were observed between rural and urban school children for the use of oral hygiene aids, frequency of tooth brushing, and dental services utilization. Dental caries level was significantly higher (P < 0.03 for rural children. Decayed teeth (DT component constituted majority of decayed, missing, and filled teeth (FT in both population. 55.6% of the rural school children required treatment compared to 42.4% of urban school children. Mean Oral Hygiene Index-Simplified values, mean DT, and FT were statistically significant for urban and rural school children. Logistic regression analysis showed that government or private school, dental care utilization, socioeconomic status, and malocclusion status were significantly associated with dental caries. Conclusion: Poor oral health and high treatment needs of children belonging to low socioeconomic background is an alarming situation. Strengthening of oral health care in the rural and underprivileged section should be priority of the policymakers.
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Management of groundwater in urban centers: A case study; Greater Dammam Metropolitan Area
International Nuclear Information System (INIS)
Abderrahman, Walid A.; Elamin, Abdalla S.; Al-Harazin, Ibrahim M.; Eqnaibi, Badie S.
2007-01-01
Effective management of groundwater resources in urban centers of arid regions is vital for sustainable development and groundwater protection especially with rapid growth of water demands under water stress conditions. Greater Dammam Metropolitan Area is a good example of rapid growing urban center due to comprehensive development and population growth. The water demand has increased by many times during the last three decades. Groundwater from local aquifers namely Dammam and Umm Er Radhuma, supplies more than 85% of the total water demands. The aquifers have been subjected to extensive and increasing groundwater pumping especially during last three decades. Negative impacts such as significant decline in water levels have been experienced in the area. A new groundwater management scheme in terms of improving the long-term water pumping policies is required for protection of the aquifers groundwater productivity. A special numerical simulation model of the multi-aquifer system including Dammam and Umm Er Radhuma aquifers has been developed to assess the behavior of the aquifer system under long term water stresses in Dammam Metropolitan Area. The developed numerical simulation model has been utilized to predict the responses of the aquifer system in terms of decline in terms of water level under different pumping schemes from the two aquifers during the next 30 years. The model results have postulated the importance of Umm Er Radhuma (UER) aquifer as a major water supply source to Dammam Metropolitan Area, as well as potential recharge source of more than 30% of the total water pumped from Dammam aquifer. These findings have been utilized in improving present and future groundwater management and conservation for the study area. Similar techniques can be used to improve the groundwater management in other parts of the country as well as other arid regions. (author)
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Larson, S; Chapman, S; Spetz, J; Brindis, CD
2017-01-01
Children and adolescents exposed to chronic trauma have a greater risk for mental health disorders and school failure. Children and adolescents of minority racial/ethnic groups and those living in poverty are at greater risk of exposure to trauma and less likely to have access to mental health services. School-based health centers (SBHCs) may be one strategy to decrease health disparities.Empirical studies between 2003 and 2013 of US pediatric populations and of US SBHCs were included if rese...
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Uzokwe, V. N. E. N.; Muchelo, R. O.; Odeh, I. A.
2015-12-01
In Sub-Saharan Africa (SSA), urban intensification and expansion are increasing at alarming rates due to rapid population growth and rural-to-urban migration. This has led to the premise that the proportion of SSA urban residents most vulnerable to food insecurity is the highest in the world. Using a focused survey and multi-temporal (decadal) land use/cover classification of Landsat images, we explored the effect of urban intensification and expansion on urban agriculture and food security, focusing on a megacity and a regional center in Uganda: Kampala and Mbarara, respectively. We found that food insecurity arose due to a number of reasons, among which are: i) expansion and intensification of of urban settlements into previously productive agricultural lands in urban and peri-urban areas; ii) loss of predominantly young (rural agricultural) adult labor force to urban centers, leading to decline in rural food production; iii) lack of proper urban planning incorporating green and agricultural development leading to low productive market garden systems. We discussed these outcomes in light of existing studies which estimated that urban agriculture alone supports over 800 million people globally and accounts for 15-20% of world food supply. In spite of this relatively low contribution by urban/peri-urban agriculture, it probably accounts for higher proportion of food supply to urban poor in SSA and thus are most vulnerable to the loss of urban and peri-urban agricultural land. Further recommendations require policy makers and urban planners to team up to design a suitable framework for sustainable urban planning and development.
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Carnes, M; VandenBosche, G; Agatisa, P K; Hirshfield, A; Dan, A; Shaver, J L; Murasko, D; McLaughlin, M
2001-01-01
While the number of women entering U.S. medical schools has risen substantially in the past 25 years, the number of women in leadership positions in academic medicine is disproportionately small. The traditional pathway to academic leadership is through research. Women's health research is an ideal venue to fill the pipeline with talented women physicians and scientists who may become academic leaders in positions where they can promote positive change in women's health as well as mentor other women. The Office on Women's Health (OWH) in the U.S. Department of Health and Human Services has contracted with 18 academic medical centers to develop National Centers of Excellence in Women's Health. Emphasizing the integral link between women's health and women leaders, each of the Centers of Excellence must develop a leadership plan for women in academic medicine as part of the contract requirements. This paper describes the training programs in women's health research that have developed at five of the academic medical centers: the University of Wisconsin, Magee Women's Hospital, the University of Maryland, Medical College of Pennsylvania Hahnemann University, and the University of Illinois at Chicago. We discuss some of the challenges faced for both initiation and future viability of these programs as well as criteria by which these programs will be evaluated for success.
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Liu, Xiaojun; Zhu, Hui; Hu, Yongxin; Feng, Sha; Chu, Yuanyuan; Wu, Yanyan; Wang, Chiyu; Zhang, Yuxuan; Yuan, Zhaokang; Lu, Yuanan
2016-01-01
This study assessed the public’s health risk awareness of urban air pollution triggered by three megacities in China, and the data are the responses from a sample size of 3868 megacity inhabitants from Shanghai, Nanchang and Wuhan. Descriptive analyses were used to summarize the respondents’ demographics, perceived health risks from air pollution and sources of health-related knowledge on urban air pollution. Chi-square tests were used to examine if participants’ demographics were associated with participant’s general attitudes towards current air quality and the three perceived highest health risks due to urban air pollution. We found low rate of satisfaction of current urban air quality as well as poor knowledge of air pollution related indicator. Participants’ gender, age and travel experience were found to be associated with the satisfaction of current air quality. The knowledge of air pollution related indicator was significantly affected by respondents’ education, monthly income, health status, and sites of study. As many as 46.23% of the participants expressed their feelings of anxiety when exposed to polluted air, especially females, older adults and those with poor health conditions. Most participants believed that coughs/colds, eye problems and skin allergies were the three highest health risks due to urban air pollution based on public education through television/radio, internet and newspaper/magazine. Further public health education is needed to improve public awareness of air pollution and its effects. PMID:27571088
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The occupational safety of health professionals working at community and family health centers.
Ozturk, Havva; Babacan, Elif
2014-10-01
Healthcare professionals encounter many medical risks while providing healthcare services to individuals and the community. Thus, occupational safety studies are very important in health care organizations. They involve studies performed to establish legal, technical, and medical measures that must be taken to prevent employees from sustaining physical or mental damage because of work hazards. This study was conducted to determine if the occupational safety of health personnel at community and family health centers (CHC and FHC) has been achieved. The population of this cross-sectional study comprised 507 nurses, 199 physicians, and 237 other medical personnel working at a total of 18 family health centers (FHC) and community health centers (CHC) in Trabzon, Turkey. The sample consisted of a total of 418 nurses, 156 physicians, and 123 other medical personnel. Sampling method was not used, and the researchers tried to reach the whole population. Data were gathered with the Occupational Safety Scale (OSS) and a questionnaire regarding demographic characteristics and occupational safety. According to the evaluations of all the medical personnel, the mean ± SD of total score of the OSS was 3.57 ± 0.98; of the OSS's subscales, the mean ± SD of the health screening and registry systems was 2.76 ± 1.44, of occupational diseases and problems was 3.04 ± 1.3 and critical fields control was 3.12 ± 1.62. In addition, occupational safety was found more insufficient by nurses (F = 14.18; P occupational safety to be insufficient as related to protective and supportive activities.
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Sustaining the edge: factors influencing strategy selection in academic health centers.
Walsh, Anne M; Szabat, Kathryn
2002-01-01
Competition within the acute care sector as well as increased penetration by managed care organizations has influenced the structure and role of academic health centers during the past decade. The market factors confronting academic health centers are not dissimilar from conditions that confront other organizations competing in mature industries characterized by declining profitability and intense rivalry for market share. When confronted with intense competition or adverse external events, organizations in other industries have responded to potential threats by forming alliances, developing joint ventures, or merging with another firm to maintain their competitive advantage. Although mergers and acquisitions dominated the strategic landscape in the healthcare industry during the past decade, recent evidence suggests that other types of strategic ventures may offer similar economic and contracting benefits to member organizations. Academic health centers have traditionally been involved in network relationships with multiple partners via their shared technology, collaborative research, and joint educational endeavors. These quasi-organizational relationships appear to have provided a framework for strategic decisions and allowed executives of academic health centers to select strategies that were competitive yet closely aligned with their organizational mission. The analysis of factors that influenced strategy selection by executives of academic health centers suggests a deliberate and methodical approach to achieving market share objectives, expanding managed care contracts, and developing physician networks.
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Westaway, M S; Viljoen, E; Rudolph, M J
1999-04-01
Interviews were conducted with 294 black residents (155 females and 138 males) of a peri-urban informal settlement in Gauteng to ascertain utilisation of oral health services, oral health needs and oral health status. Only 37 per cent of the sample had consulted a dentist or medical practitioner, usually for extractions. Teenagers and employed persons were significantly less likely to utilise dentists than the older age groups and unemployed persons. Forty per cent were currently experiencing oral health problems such as a sore mouth, tooth decay and bleeding/painful gums. Two hundred and twelve (73 per cent) interviewees wanted dental treatment or advice. Residents who rated their oral health status as fair or poor appeared to have the greatest need for oral health services. The use of interviews appears to be a cost-effective method of determining oral morbidity.
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MacCarthy, Sarah; Brignol, Sandra; Reddy, Manasa; Nunn, Amy; Dourado, Ines
2014-12-22
Late presentation to testing, treatment and continued care has detrimental impacts on the health of HIV-positive individuals as well as their sexual partners' health. Men who have sex with men (MSM) experience disproportionately high rates of HIV both globally and in Brazil. However, the factors that inhibit linkage to care among MSM remain unclear. We conducted a cross-sectional study of HIV-positive MSM (n = 740) enrolled in HIV/AIDS services in a large urban center of Brazil from August 2010 to June 2011. Descriptive, bivariate and multivariate statistics were conducted using STATA 12 to examine the relationship between a range of variables and late presentation, defined as having a first CD4 count make currently invisible people, visible.
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Directory of Open Access Journals (Sweden)
Ahmad-Reza Farsar
2015-02-01
Full Text Available Background and Objective: Health volunteers are the women who do charity work to prevent, protect and promote the health status of the covered neighbors and hereby cooperate with the health centers. The aim of this study was to compare the health volunteer's performance in the covered health centers by Shahid Beheshti University of Medical Sciences.Materials and Methods: This descriptive- analytical study was performed by the participation of 2060 Health volunteers, who were cooperating with 90 covered health centers by Shahid Beheshti University of Medical Sciences. These include Shomal, Shargh, Shemiranat, Pakdasht, Damavand and Firoozkooh. We used census sampling method. Demographic data was gathered through interviews with the health volunteers and their performance evaluated by the supervisor of the volunteers; through the evaluation forms and these data gathered together.Results: The mean (SD of the health volunteers performance was 30.9 (16.4 in all centers. They were 35.1 (22 in Shargh, 34 (14.5 in Shomal, 32 (11.3 in Firoozkooh, 28.3 (14 in Shemiranat, 7.9 (9.2 in Damavand and 23.6 (8.5 in Pakdasht respectively. The mean (SD of the efficacy of health volunteers was 8.6 (9.9 in all centers. They were 11.7 (5.6 in Firoozkooh, 10.7 (15.7 in Shargh, 9.4 (6.8 in Shomal, 7.9 (4.9 in Damavand, 7.9 (6.1 in Shemiranat and 4.6 (4.3 in Pakdasht respectively. Older and married volunteers with more experience performed better. There was no significant relationship between the efficacy of health volunteers with their literacy level, employment status and absorber of them. Conclusion: The health volunteers of Shomal, Shargh and Firoozkooh had the best performances respectively. The performances of those in Shemiranat, Damavand and Pakdasht were less than the overall health centers’ mean score. The efficacy score of Firoozkooh, Shomal and Shargh health centers were above the overall health centers’ mean score respectively
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Zhu, Kun; Zhang, Luying; Yuan, Shasha; Zhang, Xiaojuan; Zhang, Zhiruo
2017-11-07
China is in the process of integrating the new cooperative medical scheme (NCMS) and the urban residents' basic medical insurance system (URBMI) into the urban and rural residents' basic medical insurance system (URRBMI). However, how to integrate the financing policies of NCMS and URBMI has not been described in detail. This paper attempts to illustrate the differences between the financing mechanisms of NCMS and URBMI, to analyze financing inequity between urban and rural residents and to identify financing mechanisms for integrating urban and rural residents' medical insurance systems. Financing data for NCMS and URBMI (from 2008 to 2015) was collected from the China health statistics yearbook, the China health and family planning statistics yearbook, the National Handbook of NCMS Information, the China human resources and social security statistics yearbook, and the China social security yearbook. "Ability to pay" was introduced to measure inequity in health financing. Individual contributions to NCMS and URBMI as a function of per capita disposable income was used to analyze equity in health financing between rural and urban residents. URBMI had a financing mechanism that was similar to that used by NCMS in that public finance accounted for more than three quarters of the pooling funds. The scale of financing for NCMS was less than 5% of the per capita net income of rural residents and less than 2% of the per capita disposable income of urban residents for URBMI. Individual contributions to the NCMS and URBMI funds were less than 1% of their disposable and net incomes. Inequity in health financing between urban and rural residents in China was not improved as expected with the introduction of NCMS and URBMI. The role of the central government and local governments in financing NCMS and URBMI was oscillating in the past decade. The scale of financing for URRBMI is insufficient for the increasing demands for medical services from the insured. The pooling fund
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Opportunities for Increasing Human Papillomavirus Vaccine Provision in School Health Centers
Moss, Jennifer L.; Feld, Ashley L.; O'Malley, Brittany; Entzel, Pamela; Smith, Jennifer S.; Gilkey, Melissa B.; Brewer, Noel T.
2014-01-01
Background: Uptake of human papillomavirus (HPV) vaccine remains low among adolescents in the United States. We sought to assess barriers to HPV vaccine provision in school health centers to inform subsequent interventions. Methods: We conducted structured interviews in the fall of 2010 with staff from all 33 school health centers in North…
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Managing the risks of on-site health centers.
Gorman, Kathleen M; Miller, Ross M
2011-11-01
This review sought to assess compliance concerns, determine risk management strategies, and identify opportunities for future research to contribute to employers' understanding of the laws and regulations that apply to on-site care. A comprehensive review of databases, professional organizations' websites, and journals resulted in 22 publications reporting on the consequences of noncompliance among on-site health centers accepted for inclusion. None of those studies reported a study design or quantifiable outcome data. Two noncompliance themes were repeated among the publications. First, direct penalties included fines, civil actions, loss of licensure, and, potentially, criminal charges. Second, noncompliance also resulted in indirect costs such as employee mistrust and lowered standards of care, which jeopardize on-site health centers' ability to demonstrate a return on investment. Further research with rigorous methodology is needed to inform employer decisions about on-site health services and associated risk management. Copyright 2011, SLACK Incorporated.
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Mental health in a context of urban poverty: a qualitative approach
Directory of Open Access Journals (Sweden)
Carolina Martínez S
2009-05-01
Full Text Available Objective: With the premise that there is a strong relationship between mental health problems and the characteristics of the world in which people live, this article analyzes the findings of a qualitative inquiry about the situation of a small group of low-income urban families in Mexico at the end of the 20th century. It proposes also a reflection about the contributions of this kind of approach to achieve a better understanding of the complex constellations that give rise to mental health disturbances in each context. Methodology:The interpretation offered in this paper is oriented by a postkleinian psychoanalytic model developed for the study of the influence of the family and community contexts on the person’s psychic structure. The data analyzed was collected several years ago by means of direct observation and in-depth personal interviews to each member of twenty low-income urban families living in the south of Mexico City. Results:The analysis oriented by this model showed different types of family emotional dynamics and its influence on the psychic structure and function of their members. It was found a low coverage of public health services for this group of population, and specially a lack of preventive and curative mental health services.
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Cultural health capital and the interactional dynamics of patient-centered care.
Dubbin, Leslie A; Chang, Jamie Suki; Shim, Janet K
2013-09-01
As intuitive and inviting as it may appear, the concept of patient-centered care has been difficult to conceptualize, institutionalize and operationalize. Informed by Bourdieu's concepts of cultural capital and habitus, we employ the framework of cultural health capital to uncover the ways in which both patients' and providers' cultural resources, assets, and interactional styles influence their abilities to mutually achieve patient-centered care. Cultural health capital is defined as a specialized collection of cultural skills, attitudes, behaviors and interactional styles that are valued, leveraged, and exchanged by both patients and providers during clinical interactions. In this paper, we report the findings of a qualitative study conducted from 2010 to 2011 in the Western United States. We investigated the various elements of cultural health capital, how patients and providers used cultural health capital to engage with each other, and how this process shaped the patient-centeredness of interactions. We find that the accomplishment of patient-centered care is highly dependent upon habitus and the cultural health capital that both patients and providers bring to health care interactions. Not only are some cultural resources more highly valued than others, their differential mobilization can facilitate or impede engagement and communication between patients and their providers. The focus of cultural health capital on the ways fundamental social inequalities are manifest in clinical interactions enables providers, patients, and health care organizations to consider how such inequalities can confound patient-centered care. Copyright © 2013 Elsevier Ltd. All rights reserved.
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Directory of Open Access Journals (Sweden)
İclal Dinçer
2013-06-01
Full Text Available Today, the big cities that are centers of innovation and creativity offer employment and training opportunities for people on the one hand, and are faced to face to uncontrolled urbanization on the other. One of the main problems of these cities is socio-cultural and spatial harmony between urban heritage and new developments. It should be recognized that it is difficult to preserve both the tangible and intangible heritage and sustainable development together with providing the quality of urban life. This article will discuss the "historic urban landscape" concept that is one of the approaches in the long term evolution of conservation and reconstruction of cities. In this evolution process, concepts of urban conservation, environmenta protection, urban archaeology, cultural landscape and the value o cultural heritage for society are the important milestones. Within this approach "historic urban landscape", decision-making processes needs to evolve towards the partnerships of state, market and civil society actors through negotiation and cooperation between them. In the article three examples from Istanbul are examined.
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Higgerson, James; Birt, Christopher A; van Ameijden, Erik; Verma, Arpana
2017-05-01
Despite much research focusing on the impact of the city condition upon health, there still remains a lack of consensus over what constitutes an urban area (UA). This study was conducted to establish comparable boundaries for the UAs participating in EURO-URHIS 2, and to test whether the sample reflected the heterogeneity of urban living. Key UA contacts ( n = 28) completed a cross-sectional questionnaire, which included where available comparison between Urban Audit city and larger urban zone (LUZ) boundaries and public health administration areas (PHAAs). Additionally, broad health and demographic indicators were sought to test for heterogeneity of the EURO-URHIS 2 sample. Urban Audit city boundaries were found to be suitable for data collection in 100% ( n = 21) of UAs where Urban Audit data were available. The remainder ( n = 7) identified PHAA boundaries akin to the 'city' level. Heterogeneity was observed in the sample for population size and infant mortality rate. Heterogeneity could not be established for male and female life expectancy. This study was able to establish comparable boundaries for EURO-URHIS 2 data collection, with the 'city' area being selected for data collection. The homogeneity of life expectancy indicators was reflective of sub-regional similarities in life expectancy, whilst population estimates and rates of infant mortality indicated the presence of heterogeneity within the sample. Future work would trial these methods with a larger number of indicators and for a larger number of UAs. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.
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Cartier, Yuri; Benmarhnia, Tarik; Brousselle, Astrid
2015-12-01
Urban outdoor air pollution (AP) is a major public health concern but the mechanisms by which interventions impact health and social inequities are rarely assessed. Health and equity impacts of policies and interventions are questioned, but managers and policy agents in various institutional contexts have very few practical tools to help them better orient interventions in sectors other than the health sector. Our objective was to create such a tool to facilitate the assessment of health impacts of urban outdoor AP interventions by non-public health experts. An iterative process of reviewing the academic literature, brainstorming, and consultation with experts was used to identify the chain of effects of urban outdoor AP and the major modifying factors. To test its applicability, the tool was applied to two interventions, the London Low Emission Zone and the Montréal BIXI public bicycle-sharing program. We identify the chain of effects, six categories of modifying factors: those controlling the source of emissions, the quantity of emissions, concentrations of emitted pollutants, their spatial distribution, personal exposure, and individual vulnerability. Modifiable and non-modifiable factors are also identified. Results are presented in the text but also graphically, as we wanted it to be a practical tool, from pollution sources to emission, exposure, and finally, health effects. The tool represents a practical first step to assessing AP-related interventions for health and equity impacts. Understanding how different factors affect health and equity through air pollution can provide insight to city policymakers pursuing Health in All Policies. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.
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DEFF Research Database (Denmark)
Performative Urban Design seeks to identify emerging trends in urban design as they are reflected in the city's architecture and spatial design. A “cultural grafting” of the inner city is taking place; architecture and art are playing a crucial, catalytic role in urban development. On the one hand...... these issues through three perspectives: •Sense Architecture; •Place-Making; and •Urban Catalysts. The articles in this volume identify relevant theoretical positions within architecture, art, and urban strategies while demonstrating relevant concepts and methodological approaches drawn from practical......, this development has been rooted in massive investments in “corporate architecture.” On the other, cities themselves have invested heavily in new cultural centers and performative urban spaces that can fulfil the growing desire for entertainment and culture. The anthology Performative Urban Design addresses...
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Improving access to care through the patient-centered medical home.
North, Stephen W; McElligot, James; Douglas, Gaye; Martin, Amanda
2014-02-01
School-based health centers (SBHCs) serve an essential role in providing access to high-quality, comprehensive care to underserved children and adolescents in more than 2,000 schools across the United States. SBHCs are an essential component of the health care safety net, and their role in the patient-centered medical home (PCMH) continues to evolve as both collaborating partners and, when fully functioning, independent PCMHs. The American Academy of Pediatrics (AAP) supports the use of SBHCs, citing the proven benefits and exciting potential as justification, but also offers caution and recommends a focus on communication within the community. Traditional "brick and mortar" SBHCs are more likely to be located in urban communities (54.2% urban versus 18.0% rural) and be in schools with more students, allowing for a greater return on investment. Current SBHCs are located in schools with an average population of 997 students. The need for a large school population to help an SBHC approach financial viability excludes children in rural communities who are more likely to attend a school with fewer than 500 students, be poor, and have difficulty accessing health care.2 The expansion of telehealth technologies allows the creation of solutions to decrease geographic barriers that have limited the growth of SBHCs in rural communities. Telehealth school-based health centers (tSBHCs) that exclusively provide services through telemedicine are operating and developing in communities where geographic barriers and financial challenges have prevented the establishment of brick and mortar SBHCs. TSBHCs are beginning to increase the number and variety of services they provide through the use of telehealth to include behavioral health, nutrition services, and pediatric specialists. Understanding the role of tSBHCs in the growth of the PCMH model is critical for using these tools to continue to improve child and adolescent health. Copyright 2014, SLACK Incorporated.
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Challenges posed by alien culture diffusion for employees of call centers in Mumbai
Hegde, Sandeep
2016-01-01
Since the last decade, there has been a tremendous growth in the call center businesses in several metropolitan and urban cities in India. Mumbai city is no exception to this sudden boom. The call center businesses employ over 500,000 nascent employees in the age group of 18-28 yrs in Mumbai. The nature of outsourced work along with the odd working hours in this industry leads to high employee attrition in the call centers. Job satisfaction, high levels of stress, health issues, employee safe...
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Schuster, Christian; Honold, Jasmin; Lauf, Steffen; Lakes, Tobia
2017-04-01
Extreme heat has tremendous adverse effects on human health. Heat stress is expected to further increase due to urbanization, an aging population, and global warming. Previous research has identified correlations between extreme heat and mortality. However, the underlying physical, behavioral, environmental, and social risk factors remain largely unknown and comprehensive quantitative investigation on an individual level is lacking. We conducted a new cross-sectional household questionnaire survey to analyze individual heat impairment (self-assessed and reported symptoms) and a large set of potential risk factors in the city of Berlin, Germany. This unique dataset (n = 474) allows for the investigation of new relationships, especially between health/fitness and urban heat stress. Our analysis found previously undocumented associations, leading us to generate new hypotheses for future research: various health/fitness variables returned the strongest associations with individual heat stress. Our primary hypothesis is that age, the most commonly used risk factor, is outperformed by health/fitness as a dominant risk factor. Related variables seem to more accurately represent humans’ cardiovascular capacity to handle elevated temperature. Among them, active travel was associated with reduced heat stress. We observed statistical associations for heat exposure regarding the individual living space but not for the neighborhood environment. Heat stress research should further investigate individual risk factors of heat stress using quantitative methodologies. It should focus more on health and fitness and systematically explore their role in adaptation strategies. The potential of health and fitness to reduce urban heat stress risk means that encouraging active travel could be an effective adaptation strategy. Through reduced CO2 emissions from urban transport, societies could reap double rewards by addressing two root causes of urban heat stress: population health and
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Multifunctional centers in rural areas
DEFF Research Database (Denmark)
Svendsen, Gunnar Lind Haase
2009-01-01
abandoned. One outcome has been closings of schools in remote rural areas. This evidently contributes to exacerbate depopulation in these areas. To stop this tendency, we need new models for high-quality, cost effective public services in rural areas as those as we find in Denmark. This chapter introduces...... ideological roots in history pointing at 19th c. national civic movements and an early 20th c. transnational Garden City movement within urban planning as crucial. Drawing on contemporary case studies of multifunctional centers in Holland and Denmark, I then suggest that public and private donors should...... invest in multifunctional centers in which the local public school is the dynamo. This in order to increase local levels of social as well as human capital. Ideally, such centers should contain both public services such as school, library and health care, private enterprises as hairdressers and banks...
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Health services at the Kennedy Space Center
Ferguson, E. B.; Humbert, P.; Long, I. D.; Tipton, D. A.
1992-01-01
Comprehensive occupational health services are provided to approximately 17,000 workers at the Kennedy Space Center and an additional 6000 on Cape Canaveral Air Force Station. These areas cover about 120,000 acres encompassing part of the Merritt Island Wild Life Refuge and wetlands which are the habitat of numerous endangered and protected species of wildlife. The services provided at the Kennedy Space Center optimally assure a safe and healthy working environment for the employees engaged in the preparation and launching of this country's Space Shuttle and other important space exploration programs.
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Area health education centers and health science library services.
West, R T; Howard, F H
1977-07-01
A study to determine the impact that the Area Health Education Center type of programs may have on health science libraries was conducted by the Extramural Programs, National Library of Medicine, in conjunction with a contract awarded by the Bureau of Health Manpower, Health Resources Administration, to develop an inventory of the AHEC type of projects in the United States. Specific study tasks included a review of these programs as they relate to library and information activities, on-site surveys on the programs to define their needs for library services and information, and a categorization of library activities. A major finding was that health science libraries and information services are generally not included in AHEC program planning and development, although information and information exchange is a fundamental part of the AHEC type of programs. This study suggests that library inadequacies are basically the result of this planning failure and of a lack of financial resources; however, many other factors may be contributory. The design and value of library activities for these programs needs explication.
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Third-world development: urbanizing for the future.
Mcilwaine, C
1997-01-01
This article reviews some issues reflected in the 1996 UN Habitat II agenda and recent research on urbanization. The themes of the 1996 Habitat conference were urban development, urban poverty, and governance, civil society, and social capital. It is expected that over 50% of total world population will live in cities in the year 2000. Cities are viewed both as engines of economic growth and centers of severe economic, environmental, and social problems. There is some disagreement about whether cities are rational economic structures or what the World Bank's urban agenda is and its relationship with macroeconomic policy. Discussions of global urban issues are criticized for their neglect of issues of equity and poverty, cultural diversity, and identity and representation. Habitat II also stressed urban sustainability. There is growing recognition that urban management involves more than the "Brown Agenda" of environmental and physical aspects of urban growth. Recent studies identify how politics and power affect people's access to basic urban services. Urban economic activity can also contribute to environmental problems. Urban growth affects the provision of health services. Although there is not a consensus on the role of cities in expanding economic and social development and the best management practices, there is sufficient evidence to indicate that urban processes are varied throughout the developing world. The links between urban and rural areas differentiate cities and expose the need to understand the role of intermediate urban areas surrounding and between larger cities. Poverty has become increasingly urbanized, but the extent of poverty is unknown. Habitat II was an unprecedented effort to engage nongovernment groups, local government staff, trade unions, and the private sector and to emphasize community participation. Networks of trust and reciprocity are key to solving poverty, inequality, and disempowerment problems.
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Reinventing the academic health center.
Kirch, Darrell G; Grigsby, R Kevin; Zolko, Wayne W; Moskowitz, Jay; Hefner, David S; Souba, Wiley W; Carubia, Josephine M; Baron, Steven D
2005-11-01
Academic health centers have faced well-documented internal and external challenges over the last decade, putting pressure on organizational leaders to develop new strategies to improve performance while simultaneously addressing employee morale, patient satisfaction, educational outcomes, and research growth. In the aftermath of a failed merger, new leaders of The Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center encountered a climate of readiness for a transformational change. In a case study of this process, nine critical success factors are described that contributed to significant performance improvement: performing a campus-wide cultural assessment and acting decisively on the results; making values explicit and active in everyday decisions; aligning corporate structure and governance to unify the academic enterprise and health system; aligning the next tier of administrative structure and function; fostering collaboration and accountability-the creation of unified campus teams; articulating a succinct, highly focused, and compelling vision and strategic plan; using the tools of mission-based management to realign resources; focusing leadership recruitment on organizational fit; and "growing your own" through broad-based leadership development. Outcomes assessment data for academic, research, and clinical performance showed significant gains between 2000 and 2004. Organizational transformation as a result of the nine factors is possible in other institutional settings and can facilitate a focus on crucial quality initiatives.
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Amoah, Padmore Adusei; Edusei, Joseph; Amuzu, David
2018-05-13
Communities and individuals in many sub-Saharan African countries often face limited access to healthcare. Hence, many rely on social networks to enhance their chances for adequate health care. While this knowledge is well-established, little is known about the nuances of how different population groups activate these networks to improve access to healthcare. This paper examines how rural and urban dwellers in the Ashanti Region in Ghana distinctively and systematically activate their social networks to enhance access to healthcare. It uses a qualitative cross-sectional design, with in-depth interviews of 79 primary participants (28 urban and 51 rural residents) in addition to the views of eight community leaders and eight health personnel. It was discovered that both intimate and distanced social networks for healthcare are activated at different periods by rural and urban residents. Four main stages of social networks activation, comprising different individuals and groups were observed among rural and urban dwellers. Among both groups, physical proximity, privacy, trust and sense of fairness, socio-cultural meaning attached to health problems, and perceived knowledge and other resources (mainly money) held in specific networks inherently influenced social network activation. The paper posits that a critical analysis of social networks may help to tailor policy contents to individuals and groups with limited access to healthcare.
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Provider Perspectives on School-Based Mental Health for Urban Minority Youth: Access and Services
Gamble, Brandon E.; Lambros, Katina M.
2014-01-01
This article provides results from a qualitative study on the efforts of school-based mental health providers (SBMHPs) who serve students in urban, suburban, and ethnically diverse settings to help families access quality mental health services. School-based mental health plays a key role in the provision of direct and indirect intervention…
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"Does Hope Change? Testing a Project-Based Health Intervention among Urban Students of Color"
Zusevics, Kaija L.; Johnson, Sheri
2014-01-01
Hope is positively correlated with educational attainment and health. Interventions based on project-based learning (PBL) may increase youth hope. This study examined how a PBL intervention affected hope among urban students of color. Students in health classes were invited to participate. A PBL health class was implemented in four classrooms. The…
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Effect of Air Pollution and Rural-Urban Difference on Mental Health of the Elderly in China.
Tian, Tao; Chen, Yuhuai; Zhu, Jing; Liu, Pengling
2015-08-01
China has become an aging society, and the mental health problem of the elderly is increasingly becoming prominent. This paper aimed to analyze the effect of air pollution and rural-urban difference on mental health of the elderly in China. Using the data from the China Health and Retirement Longitudinal Survey (CHARLS, 2013), after controlling the social demography variable via Tobit and Probit, a regression analysis of the effect of air pollution and rural-urban difference on mental health and psychological disorder was conducted on 6,630 old people (≧60 yr old) of China from February to April 2015. Mental health and psychological disorder of the elderly were measured by the CES-D score of respondents. Air pollution degree of counties and cities (n=123) were measured by SO2 emission. 27.8% of old people had psychological disorders. Air pollution significantly influenced the mental health of the elderly, showing a positive "U-shaped" curve (Phealth problems. Marriage, education, and social activities had positive effects on the mental health of the elderly. China's local governments should consider the influence of air pollution on the mental health of the elderly during economic development. This paper recommends paying attention to the difference in mental health between the urban and rural elderly when making public health policies. Governments could improve the mental health of the elderly by enriching social activities and increasing employment opportunities of the elderly.
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Women's health care: the experiences and behaviors of rural and urban lesbians in the USA.
Barefoot, K Nikki; Warren, Jacob C; Smalley, K Bryant
2017-01-01
Previous research has consistently demonstrated that, in comparison to their cisgender heterosexual counterparts, lesbians face a multitude of women's healthcare-related disparities. However, very little research has been conducted that takes an intersectionality approach to examining the potential influences of rural-urban location on the health-related needs and experiences of lesbians. The purpose of this study was to quantitatively compare rural and urban lesbians' access to women's health care, experiences with women's healthcare providers (WHCPs), and preventive behavior using a large, diverse sample of lesbians from across the USA. A total of 895 (31.1% rural and 68.9% urban) lesbian-identified cisgender women (ie not transgender) from the USA participated in the current online study. As part of a larger parent study, participants were recruited from across the USA through email communication to lesbian, gay, bisexual, and transgender (LGBT)-focused organizations and online advertisements. Participants were asked to complete a series of questions related to their women's healthcare-related experiences and behaviors (ie access to care, experiences with WHCPs, and preventive behavior). A series of χ2 analyses were utilized in order to examine rural-urban differences across dependent variables. An examination of sexual risks revealed that relatively more rural lesbians reported at least one previous male sexual partner in comparison to the urban sample of lesbians (78.1% vs 69.1%, χ2(1, N=890)=7.56, p=0.006). A similarly low percentage of rural (42.4%) and urban (42.9%) lesbians reported that they have a WHCP that they see on a regular basis for preventive care. In terms of experiences with WHCP providers, relatively fewer rural lesbians indicated that their current WHCP had discussed/recommended the human papillomavirus (HPV) vaccination in comparison to urban lesbians (27.5% vs. 37.2%; χ2 (1, N=796)=7.24, p=0.007). No other rural-urban differences in
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Tri-Service Center for Oral Health Studies (TSCOHS)
Federal Laboratory Consortium — The Tri-Service Center for Oral Health Studies (TSCOHS), a service of the Postgraduate Dental College, is chartered by the Department of Defense TRICARE Management...
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2011-06-17
... Community Mental Health Centers; Proposed Rule #0;#0;Federal Register / Vol. 76 , No. 117 / Friday June 17... (CoPs) for Community Mental Health Centers AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS... participation (CoPs) that community mental health centers (CMHCs) would have to meet in order to participate in...
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Outpatient prescription practices in rural township health centers in Sichuan Province, China
Directory of Open Access Journals (Sweden)
Jiang Qian
2012-09-01
Full Text Available Abstract Background Sichuan Province is an agricultural and economically developing province in western China. To understand practices of prescribing medications for outpatients in rural township health centers is important for the development of the rural medical and health services in this province and western China. Methods This is an observational study based on data from the 4th National Health Services Survey of China. A total of 3,059 prescriptions from 30 township health centers in Sichuan Province were collected and analyzed. Seven indicators were employed in the analyses to characterize the prescription practices. They are disease distribution, average cost per encounter, number of medications per encounter, percentage of encounters with antibiotics, percentage of encounters with glucocorticoids, percentage of encounters with combined glucocorticoids and antibiotics, and percentage of encounters with injections. Results The average medication cost per encounter was 16.30 Yuan ($2.59. About 60% of the prescriptions contained Chinese patent medicine (CPM, and almost all prescriptions (98.07% contained western medicine. 85.18% of the prescriptions contained antibiotics, of which, 24.98% contained two or more types of antibiotics; the percentage of prescriptions with glucocorticoids was 19.99%; the percentage of prescriptions with both glucocorticoids and antibiotics was 16.67%; 51.40% of the prescriptions included injections, of which, 39.90% included two or more injections. Conclusions The findings from this study demonstrated irrational medication uses of antibiotics, glucocorticoids and injections prescribed for outpatients in the rural township health centers in Sichuan Province. The reasons for irrational medication uses are not only solely due to the pursuit of maximizing benefits in the township health centers, but also more likely attributable to the lack of medical knowledge of rational medication uses among rural doctors and the
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Maketa, Vivi; Vuna, Mimy; Baloji, Sylvain; Lubanza, Symphorien; Hendrickx, David; Inocêncio da Luz, Raquel Andrea; Boelaert, Marleen; Lutumba, Pascal
2013-01-01
In Democratic Republic of Congo access to health care is limited because of many geographical and financial barriers, while quality of care is often low. Global health donors assist the country with a number of community-oriented interventions such as free distribution of bednets, antihelminthic drugs, vitamin A supplementation and vaccination campaigns, but uptake of these interventions is not always optimal. The aim of this study was to explore the perceptions of poor urban communities of the capital Kinshasa with regard to health issues in general as well as their experiences and expectations concerning facility-based health services and community-oriented health interventions. Applying an approach rooted in the grounded theory framework, focus group discussions were conducted in eight neighborhoods of poor urban areas in the city of Kinshasa in July 2011. Study participants were easily able to evoke the city's major health problems, with the notable exceptions of malnutrition and HIV/AIDS. They perceive the high out-of-pocket cost of health services as the major obstacle when seeking access to quality care. Knowledge of ongoing community-oriented health interventions seems good. Still, while the study participants agree that those interventions are beneficial; their acceptability seems to be problematic. This is chiefly put down to a lack of information and government communication about the programs and their interventions. Furthermore, the study participants referred to rumors and the deterring effect of stories about alleged harmful consequences of those interventions. Along with improving the provision and quality of general health care, the government and international actors must improve their efforts in informing the communities about disease control programs, their rationale and benefit/risk ratio. Directly engaging community members in a dialogue might be beneficial in terms of improving acceptability and overall access to health services and
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Urban Planning and Health Inequities: Looking in a Small-Scale in a City of Cape Verde.
Gonçalves, Luzia; Santos, Zélia; Amado, Miguel; Alves, Daniela; Simões, Rui; Delgado, António Pedro; Correia, Artur; Cabral, Jorge; Lapão, Luís Velez; Craveiro, Isabel
2015-01-01
The lack of high-quality data to support evidence-based policies continues to be a concern in African cities, which present marked social, economic and cultural disparities that may differently impact the health of the groups living in different urban contexts. This study explores three urban units--formal, transition and informal--of the capital of Cape Verde, in terms of overweight/obesity, cardiometabolic risk, physical activity and other aspects related to the urban environment. Quantitative and qualitative research methods were used in this intra-urban study. A proportional stratified random sample (n = 1912 adults), based on geographical coordinates of private households, was selected to apply the UPHI-STAT questionnaire. In a second stage (n = 599), local nutritionists collected anthropometric measurements (e.g., height, waist circumference) and body composition by bioelectric impedance (e.g., body weight, body fat, muscle mass). In a third stage, pedometers were used to count study participants' steps on working and non-working days for one week (n = 118). After a preliminary statistical analysis, a qualitative study was developed to complement the quantitative approach. Generalized linear models, among others, were used in the multivariate analysis. Insecurity was the main concern among survey respondents in the three units, notwithstanding with significant differences (p Verde. The higher participation of women and residents of informal unit (the most disadvantaged groups) suggests these as the priority target groups for health promotion campaigns. The link between health planning, urban planning and security of the city needs to be reinforced to minimize health, social and gender inequalities.
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Jalaludin, Bin B; Garden, Frances L
2011-09-01
Mental health can be influenced by a number of neighbourhood physical and social environmental characteristics. We aimed to determine whether urban sprawl (based on population density) in Sydney, Australia, is associated with self-rated health and psychological distress. We used a cross-sectional multilevel study design. Individual level data on self-rated health and psychological distress were obtained from the 2006 and 2007 NSW Population Health Survey. We did not find significant associations between urban sprawl and self-rated health and psychological distress after controlling for individual and area level covariates. However, positive neighbourhood factors were generally associated with better self-rated health and lower psychological distress but few of these associations were statistically significant.
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Corin, Marcela
2013-01-01
The history of the Health and Community Center (CeSAC) No 24 began 21 years ago in the Ramón Carrillo district, in Villa Soldati neighborhood. This is a marginal urban area in the south of the CABA with a population with urgent needs. The work started with a group of professionals dealing with primary care practices, and it continues up to the present. The goal of our community mental health project is the creation of spaces for prevention and well-being including art in all its expressions, with the active participation of neighbors in the coordination of many activities. Through the symbolic opening of doors and making networks visible, we opened the CeSAC to universities, scientific societies, foundations, NGOs, neighbor committees, neighborhood boards, human rights organizations, formal and informal education centers, cultural centers, churches, community radios, in order to show the vital movements of the community, as we -as a team- are an integral part of it. Our spaces, workshops and programs are a collective socio-historical construction that achieves milestones such as thinking, thinking of us, getting together and achieving the participation from the community and the continuous training for everybody working and living in Soldati. The decentralization and democratization trend, and the heterarchical management of our organization favors the possibility of catalyzing the wishes, motivations and efforts of the healthcare team, neighbors and network nodes, thus benefiting the creative work that turns a dream into a hopeful reality.
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Health-related fitness of urban children in Suriname : an ethnic variety
Walhain, Fenna; Declerck, Marlies; de Vries, J; Veeger, H.E.J.; Ledebt, A.
Objective: The aim of our study was to investigate the health-related fitness (HRF) of 11-year-old children living in an urban area in Suriname, taking into account the difference between the five main ethnicities from Suriname. Design and Method: Cross-sectionally, performance on the HRF
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Ma, Jun; Li, Shujun; Cai, Yuyang; Sun, Wei; Liu, Qiaohong
2018-01-01
Urban areas usually display better health care services than rural areas, but data about suburban areas in China are lacking. Hence, this cross-sectional study compared the utilization of community basic medical services in Shanghai urban and suburban areas between 2009 and 2014. These data were used to improve the efficiency of community health service utilization and to provide a reference for solving the main health problems of the residents in urban and suburban areas of Shanghai. Using a two-stage random sampling method, questionnaires were completed by 73 community health service centers that were randomly selected from six districts that were also randomly selected from 17 counties in Shanghai. Descriptive statistics, principal component analysis, and forecast analysis were used to complete a gap analysis of basic health services utilization quality between urban and suburban areas. During the 6-year study period, there was an increasing trend toward greater efficiency of basic medical service provision, benefits of basic medical service provision, effectiveness of common chronic disease management, overall satisfaction of community residents, and two-way referral effects. In addition to the implementation effect of hypertension management and two-way referral, the remaining indicators showed a superior effect in urban areas compared with the suburbs (Pservice utilization. Comprehensive satisfaction clearly improved as well. Nevertheless, there was an imbalance in health service utilization between urban and suburban areas. There is a need for the health administrative department to address this imbalance between urban and suburban institutions and to provide the required support to underdeveloped areas to improve resident satisfaction. PMID:29791470
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Guo, Lijun; Bao, Yong; Ma, Jun; Li, Shujun; Cai, Yuyang; Sun, Wei; Liu, Qiaohong
2018-01-01
Urban areas usually display better health care services than rural areas, but data about suburban areas in China are lacking. Hence, this cross-sectional study compared the utilization of community basic medical services in Shanghai urban and suburban areas between 2009 and 2014. These data were used to improve the efficiency of community health service utilization and to provide a reference for solving the main health problems of the residents in urban and suburban areas of Shanghai. Using a two-stage random sampling method, questionnaires were completed by 73 community health service centers that were randomly selected from six districts that were also randomly selected from 17 counties in Shanghai. Descriptive statistics, principal component analysis, and forecast analysis were used to complete a gap analysis of basic health services utilization quality between urban and suburban areas. During the 6-year study period, there was an increasing trend toward greater efficiency of basic medical service provision, benefits of basic medical service provision, effectiveness of common chronic disease management, overall satisfaction of community residents, and two-way referral effects. In addition to the implementation effect of hypertension management and two-way referral, the remaining indicators showed a superior effect in urban areas compared with the suburbs (Pservice utilization. Comprehensive satisfaction clearly improved as well. Nevertheless, there was an imbalance in health service utilization between urban and suburban areas. There is a need for the health administrative department to address this imbalance between urban and suburban institutions and to provide the required support to underdeveloped areas to improve resident satisfaction.
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Strategies to improve chronic disease management in seven metro Boston community health centers.
Ndumele, Chima D; Russell, Beverley E; Ayanian, John Z; Landon, Bruce E; Keegan, Thomas; O'Malley, A James; Hicks, Leroi S
2009-01-01
The Community, Health Center, and Academic Medicine Partnership Project (CHAMPP) is a partnership between medical researchers, community health centers (CHCs), and a community advisory committee focused on reducing cardiovascular morbidity related to hypertension and diabetes for non-Hispanic Black and Hispanic populations in Boston, Massachusetts. We conducted site visits at seven participating CHCs, located in Boston. The visits were to solicit health center staff opinions about site-specific barriers and enabling factors for optimum preventative cardiovascular care for racial/ethnic minority patients receiving hypertension and diabetes care at their centers. Site visits included a tour of each health center and a series of directed interviews with center personnel. Site visit notes were reviewed to identify themes that emerged during the course of each site visit. A summary matrix was developed for each health center, which included information regarding the most salient and persistent themes of the visit. Site visits uncovered several patient-, provider-, CHC-, and community-based factors that either facilitate or hinder optimal care of chronic disease patients. Commonly referenced barriers included the need for improved patient adherence to provider recommendations; insufficient time for providers to address complex health issues presented by patients and the need for a broader range of healthier food options in surrounding communities. Interactive patient groups and community health workers (CHWs) have been well received when implemented. Recommendations included adopting case management as a part of usual care for chronic disease patients; additionally, widespread implementation of CHWs may to provide a platform for more comprehensive care for patients.
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Pan, Jay; Tian, Sen; Zhou, Qin; Han, Wei
2016-09-01
Equity is one of the essential objectives of the social health insurance. This article evaluates the benefit distribution of the China's Urban Residents' Basic Medical Insurance (URBMI), covering 300 million urban populations. Using the URBMI Household Survey data fielded between 2007 and 2011, we estimate the benefit distribution by the two-part model, and find that the URBMI beneficiaries from lower income groups benefited less than that of higher income groups. In other words, government subsidy that was supposed to promote the universal coverage of health care flew more to the rich. Our study provides new evidence on China's health insurance system reform, and it bears meaningful policy implication for other developing countries facing similar challenges on the way to universal coverage of health insurance. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.
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The New Global Urban Realm: Complex, Connected, Diffuse, and Diverse Social-Ecological Systems
Directory of Open Access Journals (Sweden)
Melissa R. McHale
2015-04-01
Full Text Available Urbanization continues to be a transformative process globally, affecting ecosystem integrity and the health and well being of people around the world. Although cities tend to be centers for both the production and consumption of goods and services that degrade natural environments, there is also evidence that urban ecosystems can play a positive role in sustainability efforts. Despite the fact that most of the urbanization is now occurring in the developing countries of the Global South, much of what we know about urban ecosystems has been developed from studying cities in the United States and across Europe. We propose a conceptual framework to broaden the development of urban ecological research and its application to sustainability. Our framework describes four key contemporary urban features that should be accounted for in any attempt to build a unified theory of cities that contributes to urban sustainability efforts. We evaluated a range of examples from cities around the world, highlighting how urban areas are complex, connected, diffuse and diverse and what these interconnected features mean for the study of urban ecosystems and sustainability.
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77 FR 2548 - Board of Scientific Counselors, National Center for Health Statistics
2012-01-18
... Scientific Counselors, National Center for Health Statistics In accordance with section 10(a)(2) of the...), National Center for Health Statistics (NCHS) announces the following meeting of the aforementioned...; review of the ambulatory and hospital care statistics program; a discussion of the NHANES genetics...
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Evaluating Health Co-Benefits of Climate Change Mitigation in Urban Mobility.
Wolkinger, Brigitte; Haas, Willi; Bachner, Gabriel; Weisz, Ulli; Steininger, Karl; Hutter, Hans-Peter; Delcour, Jennifer; Griebler, Robert; Mittelbach, Bernhard; Maier, Philipp; Reifeltshammer, Raphael
2018-04-28
There is growing recognition that implementation of low-carbon policies in urban passenger transport has near-term health co-benefits through increased physical activity and improved air quality. Nevertheless, co-benefits and related cost reductions are often not taken into account in decision processes, likely because they are not easy to capture. In an interdisciplinary multi-model approach we address this gap, investigating the co-benefits resulting from increased physical activity and improved air quality due to climate mitigation policies for three urban areas. Additionally we take a (macro-)economic perspective, since that is the ultimate interest of policy-makers. Methodologically, we link a transport modelling tool, a transport emission model, an emission dispersion model, a health model and a macroeconomic Computable General Equilibrium (CGE) model to analyze three climate change mitigation scenarios. We show that higher levels of physical exercise and reduced exposure to pollutants due to mitigation measures substantially decrease morbidity and mortality. Expenditures are mainly born by the public sector but are mostly offset by the emerging co-benefits. Our macroeconomic results indicate a strong positive welfare effect, yet with slightly negative GDP and employment effects. We conclude that considering economic co-benefits of climate change mitigation policies in urban mobility can be put forward as a forceful argument for policy makers to take action.
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Zhang, Xufan; Dupre, Matthew E; Qiu, Li; Zhou, Wei; Zhao, Yuan; Gu, Danan
2017-07-19
Studies have shown that inadequate access to healthcare is associated with lower levels of health and well-being in older adults. Studies have also shown significant urban-rural differences in access to healthcare in developing countries such as China. However, there is limited evidence of whether the association between access to healthcare and health outcomes differs by urban-rural residence at older ages in China. Four waves of data (2005, 2008/2009, 2011/2012, and 2014) from the largest national longitudinal survey of adults aged 65 and older in mainland China (n = 26,604) were used for analysis. The association between inadequate access to healthcare (y/n) and multiple health outcomes were examined-including instrumental activities of daily living (IADL) disability, ADL disability, cognitive impairment, and all-cause mortality. A series of multivariate models were used to obtain robust estimates and to account for various covariates associated with access to healthcare and/or health outcomes. All models were stratified by urban-rural residence. Inadequate access to healthcare was significantly higher among older adults in rural areas than in urban areas (9.1% vs. 5.4%; p China. The associations between access to healthcare and health outcomes were generally stronger among older adults in rural areas than in urban areas. Our findings underscore the importance of providing adequate access to healthcare for older adults-particularly for those living in rural areas in developing countries such as China.
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Urban Air Environmental Health Indicators for Kuala Lumpur City
International Nuclear Information System (INIS)
Leh, O.L.H.; Shaharuddin Ahmad; Kadaruddin Aiyub; Yaakob Mohd Jani; Hwa, T.K.
2012-01-01
Air environmental health indicators were defined operationally as a combination of air quality and air-related health indicators. Clean air is a basic precondition of human health. Air pollutants had been identified with potential negative impact on health especially on respiratory and cardiovascular diseases. Thus, studies are necessary to identify and understand the state of environmental health. This study was aimed to examine and analyses the air environmental health condition in city of Kuala Lumpur by using a set of indicators. House to house questionnaire survey was carried out to collect air-related health data, and air quality sampling was carried out to identify ambient air quality level of the city. In general, city of Kuala Lumpur was found to have a moderate level of air quality. Air-related illnesses indicated by acute respiratory infection and asthma were found to be higher in more developed or higher density zones, as compared to other zones. Besides, air-related illnesses were significantly correlated to respondents exposure to air pollution. The findings imply that human health can be improved by managing the urban development and its environmental quality properly. (author)
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Islam, M Mazharul; Azad, Kazi Md Abul Kalam
2008-01-01
This paper analyses the levels and trends of childhood mortality in urban Bangladesh, and examines whether children's survival chances are poorer among the urban migrants and urban poor. It also examines the determinants of child survival in urban Bangladesh. Data come from the 1999-2000 Bangladesh Demographic and Health Survey. The results indicate that, although the indices of infant and child mortality are consistently better in urban areas, the urban-rural differentials in childhood mortality have diminished in recent years. The study identifies two distinct child morality regimes in urban Bangladesh: one for urban natives and one for rural-urban migrants. Under-five mortality is higher among children born to urban migrants compared with children born to life-long urban natives (102 and 62 per 1000 live births, respectively). The migrant-native mortality differentials more-or-less correspond with the differences in socioeconomic status. Like childhood mortality rates, rural-urban migrants seem to be moderately disadvantaged by economic status compared with their urban native counterparts. Within the urban areas, the child survival status is even worse among the migrant poor than among the average urban poor, especially recent migrants. This poor-non-poor differential in childhood mortality is higher in urban areas than in rural areas. The study findings indicate that rapid growth of the urban population in recent years due to rural-to-urban migration, coupled with higher risk of mortality among migrant's children, may be considered as one of the major explanations for slower decline in under-five mortality in urban Bangladesh, thus diminishing urban-rural differentials in childhood mortality in Bangladesh. The study demonstrates that housing conditions and access to safe drinking water and hygienic toilet facilities are the most critical determinants of child survival in urban areas, even after controlling for migration status. The findings of the study may
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Staeheli, Martha; Aseltine, Robert H; Schilling, Elizabeth; Anderson, Daren; Gould, Bruce
2017-01-01
Behavioral health disorders remain under recognized and under diagnosed among urban primary care patients. Screening patients for such problems is widely recommended, yet is challenging to do in a brief primary care encounter, particularly for this socially and medically complex patient population. In 2013, intervention patients at an urban Connecticut primary clinic were screened for post-traumatic stress disorder, depression, and risky drinking (n = 146) using an electronic tablet-based screening tool. Screening data were compared to electronic health record data from control patients (n = 129) to assess differences in the prevalence of behavioral health problems, rates of follow-up care, and the rate of newly identified cases in the intervention group. Results from logistic regressions indicated that both groups had similar rates of disorder at baseline. Patients in the intervention group were five times more likely to be identified with depression (p Post-traumatic stress disorder was virtually unrecognized among controls but was observed in 23% of the intervention group (p behavioral health problems identified in the intervention group were new cases. Follow-up rates were significantly higher in the intervention group relative to controls, but were low overall. This tablet-based electronic screening tool identified significantly higher rates of behavioral health disorders than have been previously reported for this patient population. Electronic risk screening using patient-reported outcome measures offers an efficient approach to improving the identification of behavioral health problems and improving rates of follow-up care.
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Green Space Attachment and Health: A Comparative Study in Two Urban Neighborhoods.
Zhang, Yang; van Dijk, Terry; Tang, Jianjun; van den Berg, Agnes E
2015-11-12
The positive relationships between urban green space and health have been well documented. Little is known, however, about the role of residents' emotional attachment to local green spaces in these relationships, and how attachment to green spaces and health may be promoted by the availability of accessible and usable green spaces. The present research aimed to examine the links between self-reported health, attachment to green space, and the availability of accessible and usable green spaces. Data were collected via paper-mailed surveys in two neighborhoods (n = 223) of a medium-sized Dutch city in the Netherlands. These neighborhoods differ in the perceived and objectively measured accessibility and usability of green spaces, but are matched in the physically available amount of urban green space, as well as in demographic and socio-economic status, and housing conditions. Four dimensions of green space attachment were identified through confirmatory factor analysis: place dependence, affective attachment, place identity and social bonding. The results show greater attachment to local green space and better self-reported mental health in the neighborhood with higher availability of accessible and usable green spaces. The two neighborhoods did not differ, however, in physical and general health. Structural Equation Modelling confirmed the neighborhood differences in green space attachment and mental health, and also revealed a positive path from green space attachment to mental health. These findings convey the message that we should make green places, instead of green spaces.
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Green Space Attachment and Health: A Comparative Study in Two Urban Neighborhoods
Directory of Open Access Journals (Sweden)
Yang Zhang
2015-11-01
Full Text Available The positive relationships between urban green space and health have been well documented. Little is known, however, about the role of residents’ emotional attachment to local green spaces in these relationships, and how attachment to green spaces and health may be promoted by the availability of accessible and usable green spaces. The present research aimed to examine the links between self-reported health, attachment to green space, and the availability of accessible and usable green spaces. Data were collected via paper-mailed surveys in two neighborhoods (n = 223 of a medium-sized Dutch city in the Netherlands. These neighborhoods differ in the perceived and objectively measured accessibility and usability of green spaces, but are matched in the physically available amount of urban green space, as well as in demographic and socio-economic status, and housing conditions. Four dimensions of green space attachment were identified through confirmatory factor analysis: place dependence, affective attachment, place identity and social bonding. The results show greater attachment to local green space and better self-reported mental health in the neighborhood with higher availability of accessible and usable green spaces. The two neighborhoods did not differ, however, in physical and general health. Structural Equation Modelling confirmed the neighborhood differences in green space attachment and mental health, and also revealed a positive path from green space attachment to mental health. These findings convey the message that we should make green places, instead of green spaces.
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Kabisch, Nadja; Haase, Dagmar; Annerstedt van den Bosch, Matilda
2016-08-04
Research suggests that there is a relationship between the health of urban populations and the availability of green and water spaces in their daily environment. In this paper, we analyze the potential intra-urban relationships between children's health determinants and outcomes and natural areas in Berlin, Germany. In particular, health indicators such as deficits in viso-motoric development in children are related to environmental indicators such as the natural area cover, natural area per capita and distance to natural areas; however, these indicators are also correlated with social determinants of health. The methodological approach used in this study included bivariate and multivariate analyses to explore the relations between health inequalities and social, socio-economic, and land use parameters. The results on a sub-district level indicated that there was a correlation between natural areas and social health determinants, both of which displayed a certain intra-urban spatial pattern. In particular, a lower percentage of natural area cover was correlated with deficits in viso-motoric development. However, results with percentage of natural area cover and per capita natural area with childhood overweight were not conclusive. No significant correlation was found for percentage of natural area cover and overweight, while significant negative correlation values were found between overweight and per capita natural area. This was identified particularly in the districts that had lower social conditions. On the other hand, the districts with the highest social conditions had the comparatively lowest levels of complete measles immunization. This study may facilitate public health work by identifying the urban areas in which the strengthening of health resources and actions should be prioritized and also calls for the inclusion of natural areas among the social health indicators included in intra-urban health inequality tools.
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Snyder, Marcie; Wilson, Kathi
2015-07-01
Urban Indigenous peoples face a disproportionate burden of ill health compared to non-Indigenous populations, and experience more frequent geographic mobility. However, most of what is known about Indigenous health is limited to rural, northern, or in the case of Canada, reserve-based populations. Little is known about the complexities of urban Indigenous health, and the differential impacts of residential mobility and urban migration remain poorly understood. Drawing upon interviews with Aboriginal movers and service providers in Winnipeg, Canada, we apply a critical population health lens, informed by holistic health, to examine these impacts. The results demonstrate mobility is an intergenerational phenomenon, influenced by colonial practices. While migration can contribute to positive health experiences, residential mobility, which is largely involuntary, and linked to stressors such as neighborhood safety, results in negative health effects. Copyright © 2015 Elsevier Ltd. All rights reserved.
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Role of public health center for nuclear disaster
International Nuclear Information System (INIS)
Okada, Tsuyoshi
2012-01-01
The role of public health center such as surveillance screening, mass decontamination, health consultation and management, and dosage of stable iodine tablets are thought by Nuclear Safety Commission in 2008. The pollution screening and decontamination, internal exposure screening and valuation, dosage of iodine tablets, health consultation of residents and risk communication, comparative evaluation of health risks, health management under the low dose exposure are discussed to handle problems by the government and local government, and to protect the right to know information. In order to prepare the serious health hazard, the children's thyroid gland test and internal exposure test and the follow-up system have to be practiced by the local government. (S.Y.)